Green-Light Autofluorescence Versus Combined Blue-Light Autofluorescence and Near-Infrared Reflectance Imaging in Geographic Atrophy Secondary to Age-Related Macular Degeneration

Pfau, Maximilian; Goerdt, Lukas; Schmitz-Valckenberg, Steffen; Mauschitz, Matthias M.; Mishra, Divyansh; Holz, Frank G.; Lindner, Moritz; Fleckenstein, Monika

doi:10.1167/iovs.17-21764

Cited by 55 publications

(60 citation statements)

References 32 publications

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“…A recent paper comparing BAF and GAF for measuring GA (both performed with RF) reported ICCs of 0.995 (GAF) and 0.991 (BAF), which were marginally smaller than the ones found in this study (Pfau et al. ).…”

Section: Discussioncontrasting

confidence: 94%

Semi‐automated quantification of geographic atrophy with blue‐light autofluorescence and spectral‐domain optical coherence tomography: a comparison between the region finder and the advanced retinal pigment epithelium tool in the clinical setting

Reumueller

Sacu

Karantonis

et al. 2019

Acta Ophthalmologica

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Purpose To compare inter‐ and intraobserver reliability and intermodality agreement on quantification of geographic atrophy, using two routinely available quantification tools, based on blue‐light fundus autofluorescence (BAF) and spectral‐domain optical coherence tomography (SD‐OCT). Methods Quantifications of atrophic lesions within the central 5 mm of 30 eyes from 30 patients (mean age: 76.1 years) were independently performed by two clinicians on BAF images using the region finder (RF; Heidelberg Engineering) and on SD‐OCT using the advanced retinal pigment epithelium tool (ARPET; Carl Zeiss Meditec) at baseline and follow‐up (mean interval: 336 days). Inter‐ and intraobserver reliability was determined by intraclass correlation coefficients (ICC) and Bland–Altmann plots. Additionally, graders rated the experienced difficulty of each measurement. Results Intraclass correlation coefficients (ICC) showed excellent inter‐ and intraobserver reliability with values between 0.994 and 0.998 for RF and slightly higher values for ARPET of 0.997 and 0.999. Bland–Altman plots showed smaller variability for ARPET. Mean interobserver differences (95% CI) for size measurements were −0.11 (−0.27; 0.05) (baseline) and −0.05 mm² (−0.18; 0.08) (follow‐up) for RF and −0.04 (−0.14; 0.06) and −0.06 mm² (−0.14; 0.02) for ARPET. Measurements of lesions were on average 0.57 mm² (0.35; 0.79) or 7.6% larger in ARPET. Lesion size between graders did not differ significantly. There was no statistically significant difference in relative enlargement rates between methods. There was poor to moderate agreement between graders when rating the experienced difficulty of each measurement. Conclusion Semi‐automated analysis of geographic atrophy with RF and ARPET is equally reliable and reproducible in clinical settings, despite both algorithms require frequent adjustment by users. The ARPET restricts size measurements to the central 5 mm, which limits its ability to fully track GA progression. Results of both tools are not interchangeable as measurements with ARPET result in larger lesion sizes.

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Section: Discussioncontrasting

confidence: 94%

Semi‐automated quantification of geographic atrophy with blue‐light autofluorescence and spectral‐domain optical coherence tomography: a comparison between the region finder and the advanced retinal pigment epithelium tool in the clinical setting

Reumueller

Sacu

Karantonis

et al. 2019

Acta Ophthalmologica

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“…Typically, assessment of retinal health is accomplished through electrophysiological recordings and psychophysical tests in conjunction with fundus photography, scanning laser ophthalmoscopy (SLO), or optical coherence tomography (OCT) imaging (1)(2)(3)(4)(5)(6). These techniques are well suited to measure the extent of retinal damage, though degeneration must be severe enough to reliably detect changes in the retina (7). Recently, OCT was applied to measure changes in the optical path through photoreceptor outer segments after visual stimulation (8,9).…”

Section: Introductionmentioning

confidence: 99%

Two-photon imaging of the mammalian retina with ultrafast pulsing laser

Palczewska¹,

Stremplewski²,

Suh³

et al. 2018

JCI Insight

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Noninvasive imaging of visual system components in vivo is critical for understanding the causal mechanisms of retinal diseases and for developing therapies for their treatment. However, ultraviolet light needed to excite endogenous fluorophores that participate in metabolic processes of the retina is highly attenuated by the anterior segment of the human eye. In contrast, 2-photon excitation fluorescence imaging with pulsed infrared light overcomes this obstacle. Reducing retinal exposure to laser radiation remains a major barrier in advancing this technology to studies in humans. To increase fluorescence intensity and reduce the requisite laser power, we modulated ultrashort laser pulses with high-order dispersion compensation and applied sensorless adaptive optics and custom image recovery software and observed an over 300% increase in fluorescence of endogenous retinal fluorophores when laser pulses were shortened from 75 fs to 20 fs. No functional or structural changes to the retina were detected after exposure to 2-photon excitation imaging light with 20-fs pulses. Moreover, wide bandwidth associated with short pulses enables excitation of multiple fluorophores with different absorption spectra and thus can provide information about their relative changes and intracellular distribution. These data constitute a substantial advancement for safe 2-photon fluorescence imaging of the human eye.

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“…Eidon contains a ''true color'' confocal scanner which captures images with three different sources: LED (440-650 nm), infrared (825-870 nm), and blue light (440-475 nm). The Eidon system separates short and long FAF emission wavelengths, obtaining a spectrally resolved FAF or color-FAF [29][30][31]. This imaging technique has revealed interesting new details in patients with IRD [32].…”

Section: Non-invasive Imaging and Widefield Application In Irdmentioning

confidence: 99%

Reviewing the Role of Ultra-Widefield Imaging in Inherited Retinal Dystrophies

et al. 2020

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Inherited retinal dystrophies (IRD) are a heterogeneous group of rare chronic disorders caused by genetically determined degeneration of photoreceptors and retinal pigment epithelium cells. Ultra-widefield (UWF) imaging is a useful diagnostic tool for evaluating retinal integrity in IRD, including Stargardt disease, retinitis pigmentosa, cone dystrophies, and Best vitelliform dystrophy. Color or pseudocolor and fundus autofluorescence images obtained with UWF provide previously unavailable information on the retinal periphery, which correlates well with visual field measurement or electroretinogram. Despite unavoidable artifacts of the UWF device, the feasibility of investigations in infants and in patients with poor fixation makes UWF imaging a precious resource in the diagnostic armamentarium for IRD.

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Green-Light Autofluorescence Versus Combined Blue-Light Autofluorescence and Near-Infrared Reflectance Imaging in Geographic Atrophy Secondary to Age-Related Macular Degeneration

Cited by 55 publications

References 32 publications

Semi‐automated quantification of geographic atrophy with blue‐light autofluorescence and spectral‐domain optical coherence tomography: a comparison between the region finder and the advanced retinal pigment epithelium tool in the clinical setting

Semi‐automated quantification of geographic atrophy with blue‐light autofluorescence and spectral‐domain optical coherence tomography: a comparison between the region finder and the advanced retinal pigment epithelium tool in the clinical setting

Two-photon imaging of the mammalian retina with ultrafast pulsing laser

Reviewing the Role of Ultra-Widefield Imaging in Inherited Retinal Dystrophies

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