In Vivo Fundus Autofluorescence in Macular Dystrophies

Rückmann, A von; Fitzke, F W; Bird, Alan C.

doi:10.1001/archopht.1997.01100150611006

Cited by 200 publications

(124 citation statements)

References 20 publications

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“…The accumulation of autofluorescent pigment is seen in multiple disorders that affect the RPE and choroid. 4,5 FAF derives from RPE and Bruch membrane, since the signal appears to be derived from the anterior to the choriocapillaris and posterior to the neuroretina. 3 In dry age-related macular degeneration (ARMD) increased FAF was found to correlate with the areas of hyperpigmentation, soft drusen, hard drusen, or normal fundus appearance.…”

Section: Introductionmentioning

confidence: 99%

Changes in fundus autofluorescence of choroidal melanomas following treatment

Amselem

Pulido

Günduz

et al. 2007

Eye

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Purpose We have previously shown that fundus autofluorescence (FAF) associated with pigmented choroidal lesions can be attributed to mainly lipofuscin (orange pigment) but also to hyperpigmentation, drusen, or fibrous metaplasia. The purpose of this study is to describe the effects of treatment on FAF in choroidal melanomas after plaque radiotherapy alone or in combination with transpupillary thermotherapy (TTT). Methods Retrospective chart review of eight consecutive patients with choroidal melanoma treated with plaque radiotherapy alone or in combination with TTT who underwent FAF photography before and after treatment. The correlation between FAF patterns and foci of orange pigment, hyperpigmentation, drusen, or fibrous metaplasia was evaluated. Results The median follow-up time was 4 (range 2-9) months. Foci of orange pigment and hyperpigmentation became larger and more numerous after treatment. Fibrous metaplasia was also increased. A complete correlation between increased FAF and orange pigment was found in all eight tumours (100%) before and after treatment. No correlation between hyperpigmentation and increased FAF was found before treatment but a partial correlation was found in all eyes after treatment. Before treatment, correlation between fibrous metaplasia was present in three eyes and increased FAF was partial in two eyes with no correlation in one case. After treatment, this correlation was partial in all presenting eyes (7). Conclusions Following treatment, choroidal melanomas may show increased FAF, mainly due to an increase in the amount of lipofuscin (orange pigment) and hyperpigmentation.

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Section: Introductionmentioning

confidence: 99%

Changes in fundus autofluorescence of choroidal melanomas following treatment

Amselem

Pulido

Günduz

et al. 2007

Eye

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“…RPE lipofuscin fluorophores accumulate with age (5,6), the greatest accretion is in RPE cells underlying the central retina (6), and the retinoid-derived fluorophores are particularly abundant in Stargardt's disease (7,8), a macular degeneration of juvenile onset. Indeed, several lines of evidence indicate that the lipofuscin fluorophores that accumulate in RPE contribute to the death of these cells in some forms of macular degeneration (5,(9)(10)(11)(12)(13).…”

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confidence: 99%

Isolation and characterization of a retinal pigment epithelial cell fluorophore: An all-trans -retinal dimer conjugate

Fishkin

Sparrow

Allikmets

et al. 2005

Proc. Natl. Acad. Sci. U.S.A.

148

171

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Several lines of investigation suggest that the nondegradable fluorophores that accumulate as lipofuscin in retinal pigment epithelium (RPE) cells contribute to the etiology of macular degeneration. Despite evidence that much of this fluorescent material may originate as inadvertent products of the retinoid cycle, the enzymatic pathway by which the 11-cis-retinal chromophore of rhodopsin is generated, the only fluorophores of the RPE to be characterized as yet have been A2E and its isomers. Here, we report the isolation and structural characterization of an additional RPE lipofuscin fluorophore that originates as a condensation product of two molecules of all-trans-retinal (ATR) dimer and forms a protonated Schiff base conjugate with phosphatidylethanolamine (PE), the latter conjugate (ATR dimer-PE) having UV-visible absorbance maxima at 285 and 506 nm. ATR dimer was found to form natively in bleached rod outer segments in vitro and when rod outer segments were incubated with ATR. HPLC analysis of eyecups that included RPE and isolated neural retina from Abcr ؊͞؊ mice and RPE isolated from human donor eyes revealed the presence of a pigment with the same UV-visible absorbance and retention time as synthetic ATR dimer-PE conjugate. Evidence that ATR dimer undergoes a photooxidation process involving the addition of oxygens at double bonds as well as an aromatic demethylation also may indicate a role for this molecule, or its derivatives, in the photoreactivity of RPE lipofuscin.W hereas the lipofuscin that is amassed by most nonproliferating cells is derived from autophagy (1), lipofuscin fluorophores of the retinal pigment epithelium (RPE) originate, in large part, from photoreceptor cells (2), with Ͼ90% of the fluorescent material being generated from conjugates formed by retinoids of the visual cycle (3, 4). RPE lipofuscin fluorophores accumulate with age (5, 6), the greatest accretion is in RPE cells underlying the central retina (6), and the retinoid-derived fluorophores are particularly abundant in Stargardt's disease (7, 8), a macular degeneration of juvenile onset. Indeed, several lines of evidence indicate that the lipofuscin fluorophores that accumulate in RPE contribute to the death of these cells in some forms of macular degeneration (5, 9-13). The loss of RPE is a critical event because it is thought that it leads to bystander-like degeneration of photoreceptors that culminates in visual impairment.As yet, the only RPE lipofuscin fluorophores that have been characterized are A2E, its 13-(Z)-double-bond isomer iso-A2E, and other minor Z-isomers of A2E (14-19). These compounds are generated by hydrolysis of the phosphate ester of A2-PE, the phosphatidyl-pyridinium bisretinoid precursor that forms in rod outer segments (ROS). The synthesis of A2-PE occurs when molecules of all-trans-retinal (ATR), instead of undergoing reduction to all-trans-retinol, form conjugates with phosphatidylethanolamine (PE) through a series of random͞nonenzyme-mediated reactions (16,19). This pyridinium bisretinoid pathway is ...

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“…12 Hereditary retinal dystrophies usually present with increased FAF, although exceptions exist. 13,14 RPE atrophy and cell loss, as in geographic atrophy or pseudoxanthoma elasticum, have been associated with decreased FAF. 15,16 FAF has also been used to study the success of selective RPE destruction by laser treatment.…”

Section: Introductionmentioning

confidence: 99%

Review of fundus autofluorescence in choroidal melanocytic lesions

Günduz

Pulido

Ezzat

et al. 2008

Eye

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Fundus autofluorescence (FAF) imaging takes advantage of the fluorescent properties of some molecules, especially lipofuscin. FAF derives mainly from retinal pigment epithelium (RPE) and Bruch's membrane. Using confocal scanning laser ophthalmoscope (cSLO) we have previously shown that FAF associated with pigmented choroidal lesions can be attributed to mainly lipofuscin (orange pigment) within the RPE. Other causes of FAF include hyperpigmentation, drusen, or fibrous metaplasia probably because they also cause lipofuscin accumulation in the overlying RPE. There is a total or partial correlation between FAF and the foci of lipofuscin and hyperpigmentation in about 90% of the cases. The FAF patterns of choroidal melanocytic lesions were classified as patchy or diffuse. The patchy pattern was defined as the presence of distinct areas of increased FAF between areas of normal autofluorescence. The diffuse pattern was characterized by the presence of increased FAF with indistinct borders over a larger part (450%) of the tumour in the absence of such intervening areas. Choroidal melanomas presented with either a diffuse or patchy pattern, whereas choroidal naevi demonstrated only the patchy pattern. Diffuse FAF pattern was more often associated with larger choroidal melanomas as well as with early venous and late hyperfluorescence on fluorescein angiography. Limitations of these observations depend on the field of depth of cSLO; thus, FAF from other planes could not be detected. Increased retinal thickness, intraretinal oedema, or presence of subretinal fluid may also affect the FAF signal.

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In Vivo Fundus Autofluorescence in Macular Dystrophies

Cited by 200 publications

References 20 publications

Changes in fundus autofluorescence of choroidal melanomas following treatment

Changes in fundus autofluorescence of choroidal melanomas following treatment

Isolation and characterization of a retinal pigment epithelial cell fluorophore: An all-trans -retinal dimer conjugate

Review of fundus autofluorescence in choroidal melanocytic lesions

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