Fundamentals and clinical relevance article pdf available in saudi journal of ophthalmology 282 april 2014 with 928 reads how we measure reads. It aids us in the understanding of the pathophysiology of different retinal disorders. All the clinical cases gathered in this atlas have been collected by a group of retina specialists who have found in eidon a useful tool to support their clinical activities. Fundus autofluorescence faf imaging is an advanced diagnostic technique for observing the fundus.
Fundus autofluorescence imaging is a recently developed noninvasive diagnostic tool which might be helpful for imaging the laser lesions. To describe autofluorescence patterns of choroidal melanocytic lesions using the heidelberg retinal angiograph 2 system hra2. Fundus autofluorescence in agerelated macular degeneration ncbi. Fundus autofluorescence ophthalmic photographers society. Fundus autofluorescence could prove a valuable diagnostic tool in helping with this diagnostic challenge. Autofluorescence is the spontaneous fluorescence that some substances present naturally. Classification of abnormal fundus autofluorescence. This study expands the range of approaches available to assist in the identification of acute zonal occult outer retinopathy by multimodal imaging and analyzes the fundus lesions by quantifying shortwavelength fundus autofluorescence and spectral. Use of fundus autofluorescence combined with optical coherence. The nuts and bolts of fundus autofluorescence imaging. During recent years, faf fundus autofluorescence imaging has been shown to be useful in various retinal diseases with regard to diagnostics, documentation of changes, identification of disease progression, and monitoring of novel therapies.
Pdf fundus autofluorescence in type 2 idiopathic macular. This is an openaccess article distributed under the terms of the creative commons attributionnon commercialno derivatives license 4. To evaluate fundus autofluorescence faf changes in patients with chronic essential hypertension htn. Fundus autofluorescence using a confocal scanning laser ophthalmoscope. Fundus autofluorescence faf is a noninvasive imaging technique that detects fluorophores, naturally occurring molecules that absorb and emit light of specified wavelengths 1. Featuring over 250 illustrations, this detailed fullcolor textbook provides uptodate information on the use of fundus autofluorescence imaging in the evaluation of retinal disease. Both zeiss visucam models are fully featured nonmydriatic and mydriatic retinal cameras with numerous onboard image capture modes fundus autofluorescence, nonmydriatic color, redfree, red, blue and enhanced visualization functionality that provide powerful diagnostic insights for optimal patient care. Hereby, faf imaging gives additional information above. In the corresponding fundus autofluorescence image right, atrophic patches are clearly delineated by decreased intensity and high contrast to nonatrophic retina. Once the oct goes live, select a preset scan pattern fast, rnfl, etc. Once the patient is aligned with the camera, begin by pushing the. Kiss noted that faf is also helpful in screening for medication toxicity. Fundus autofluorescence and rpe lipofuscin in agerelated.
Fundus autofluorescence patterns and optical coherence. Spaide, it is useful for almost any fundus disorder, including amd, retinal detachment, inherited dystrophies, central serous chorioretinopathy, vitelliform lesions, and acute zonal occult outer retinopathy azoor. Fundus autofluorescence faf imaging is able to map metabolic changes at the level of the retinal pigment epithelium rpe noninvasively in vivo. Multiple commercially available imaging systems, including the fundus camera, the confocal scanning laser ophthalmoscope, and the ultrawidefield imaging device. Pdf abstract autofluorescence photography of the retina provides important. Increased fundus autofluorescence related to outer retinal. Fundus autofluorescence faf is a novel, noninvasive method for imaging the fluorescence properties of lipofuscin and possibly other molecules with a range of absorption and emission spectra close to that of this fluorophore at the level of the rpe. Fundus autofluorescence faf imaging uses fluorescent properties of some molecules, especially lipofuscin. Fundus autofluorescence in type 2 idiopathic macular telangiectasia. Submitted by denise a krolnik photographer, kathleen a regan md, and kimberly e stepien md. Fundus autofluorescence measured in vivo by spectrophotometry has a broad excitation spectrum that peaks between 490510 nm.
The signal strength is sufficiently powerful so that only one photograph needs to be taken, instead of averaging images over time. Jerome sherman posted on may 21, 20 by optos in addition to developing instruments and devices that equip optometrists and ophthalmologists with better diagnostic capabilities, we also strive to help educate practitioners by offering clinical trainings designed to provide information on the. View enhanced pdf access article on wiley online library html view download pdf for offline viewing. Pdf clinical applications of fundus autofluorescence in retinal. Changes in fundus autofluorescence of choroidal melanomas. We compared the autofluorescence findings with those obtained with other imaging techniques. Fundus autofluorescence faf imaging of the human living eye is a relatively new. Fundus autofluorescence af is an imaging technique which visualizes lipofuscin distribution in the rpe cell monolayer. Changes of fundus autofluorescence, photoreceptor inner and outer segment junction line, and visual function in patients with retinitis pigmentosa. For decades, fundus cameras equipped with excitation and barrier filters for fluorescein angiography have occasionally been used to document highly fluorescent ocular structures such as optic nerve drusen with high iso film or monochrome digital sensors. Q does medicare cover fundus and autofluorescence photography. Fundus autofluorescence faf is a noninvasive retinal imaging technique that depicts the distribution of intrinsic fluorophores in the retina. Fundus autofluorescence in agerelated macular degeneration. Pdf fundus autofluorescence faf is a noninvasive retinal imaging modality used in clinical practice to provide a density map of lipofuscin.
This technique allows the topographic mapping of lipofuscin distribution in the rpe. Pdf a comparison of fundus autofluorescence and retinal. Speaking on fundus autofluorescence imagings contributions to eye care, dale brodsky, ceo of fundus photo, revealed the companys intentions to support and further develop advances of this important screening technique. The study of rpe can help to achieve a better understanding of amd and to find new ways of early diagnosis as well as new prognostic and progression markers for this condition. The autofluorescence image is obtained by illuminating the eye with a blue light. In the recent times, fundus autofluorescence faf has been used to. Clinical applications of fundus autofluorescence in. In this casecontrol study, 35 eyes of 35 patients with chronic essential htn lasting 5 years and 31 eyes of 31 volunteers without history. June ultrawidefield fundus autofluorescence in agerelated macular degeneration abhilash guduru 1 2 david fleischman 0 2 sunyoung shin 2 donglin zeng 0 2 james b. The tale of fundus autofluorescence imaging fundus photo. To describe and classify patterns of abnormal fundus autofluorescence faf in the junctional zone of geographic atrophy ga in patients with age related macular degeneration. Fluorophores are chemical compounds that can reemit light upon being exposed to light at a specific wavelength. To produce autofluorescence, a fluorophore absorbs a photon of the excitation wavelength, which elevates an electron to an excited, high energy state. A medicare covers fundus photography if the patient presents with a complaint that leads you to perform this test or as an adjunct to management and treatment of a known disease.
The rpe plays an important role in the physiopathology of agerelated macular degeneration amd 3, 4. Fundus observation paraposition indication dots overlap adjusting of split luminous bars two luminous dots indication type color image capture 5184 x 3456 resolution of nikon camera software supported dicom3. Fundus autofluorescence faf provides detailed insight into the health of the. Retina today use of fundus autofluorescence in amd. Fundus autofluorescence faf has recently emerged as a novel noninvasive imaging technique that uses the fluorescent properties of innate fluorophores accumulated in the retinal pigment epithelium rpe to assess the health and viability of the rpephotoreceptor complex. Recent case reports suggest faf as a promising tool for monitoring eyes with posterior uveitis helping. Reimbursement for fundus and autofluoresence photography.
Say 2 0 department of ophthalmology, kittner eye center, university of north carolina, chapel hill, north carolina, united states of america, 3 department of. Bennett, cra, octc, fops penn state hershey eye center hershey, pennsylvania. Correlation with optical coherence tomography and microperimetry nih public access introduction. Fundus autofluorescence in multiple evanescent white dot.
Fundus autofluorescence willagainrevolutionizehowweseetheretina. The basic science chapters explain the synthesis and degradation of lipofuscin, the main fluorophore in the retina generating the fundus autofluorescence signal. Quantitative autofluorescence intensities in acute zonal. Like most technology, fundus autofluorescence imaging continues to evolve. Alterations in the patterns of swaf can occur due to autofluorescence intensity loss, spatial heterogeneities, and focal or widespread increases in fluorescence. It is a noninvasive technique, making it a relatively simple and effective method for diagnosing amd. Fundus autofluorescence faf is a diagnostic imaging technique used to detect and document the presence of fluorophores in the retina. Fundus autofluorescence of choroidal nevus and melanoma. Interpretations of the fundus autofluorescence images fundus autofluorescence imaging is used to record fluorescence that may occur naturally in ocular structures or as a byproduct of a disease process. However, the observed autofluorescence signal is a summation of not only the autofluorescence originating from the rpe but also that from more anterior.
We investigated the autofluorescence characteristics of two cases of serpiginous choroiditis sc during recurrent acute episodes, and followed them until their resolution. Autofluorescent imaging of the ocular fundus relies on the stimulated emission of light from molecules in the retinal pigment epithelium rpe, sign of previous and possible future, and oxidative injury. Fundus autofluorescence is already used to evaluate inflammatory disorders affecting the chorioretinal interface. Fundus autofluorescence in abca4gene associated stargardt disease. Fundus autofluorescence patterns in central serous chorioretinopathy are helpful when considering the timing of treatment and predicting the disease status. The fluorescence emission is also broad and centered at approximately 600 nm 11,17. Autofluorescence, fluorangiography, correlated to the fundus imaging, that time by time may support or improve the diagnostic process. Fundus autofluorescence patterns and optical coherence tomography in. Changes of fundus autofluorescence, photoreceptor inner. Ultrawidefield fundus autofluorescence in agerelated. With its relative ease of use, noninvasive technique and ability to aid in the diagnosis and management of a variety of retinal disorders, fundus autofluorescence faf has increasingly become a mainstream imaging modality. In contrast, the fundus camera shows a summation of fluorescence from the fundus and consequently can image fluorescence from the retina and rpe at the same time, said dr.
Autofluorescence imaging after selective rpe laser. Digital faf images were recorded in 164 eyes of 107 patients using a confocal scanning laser ophthalmoscope cslo. The image reflected by the ocular fundus will be filtered to select only the fluorescent emission i. Fundus autofluorescence detects chemical structures called fluorophores. Fundus autofluorescence in serpiginous choroiditis. Featuring a modular design, cirrus photo lets you individually choose the diagnostic modalities and clinical insights best suited for your practice needs whether oct, color and redfree fundus imaging, fundus autofluorescence, fluorescein angiography. University of wisconsinmadison, department of ophthalmology and visualsciences. In this report we present the angiographic and autofluorescence findings of a patient with mewds. Monitoring of atrophic progression over time with fundus autofluorescence imaging, showing the natural course of the disease over time. Fundus autofluorescence fundus autofluorescence oct angiography discordance between bluelight autofluores cence and nearinfrared autofluorescence in agerelated macular degeneration given our findings of missed geographic atrophy lesions on bluepeak in 8% of eyes, clinicians should consider multi. Rubin2,4 1 school of computer science and engineering, nanjing university of science and technology, nanjing 210094, china 2 department of radiology and medicine biomedical informatics research. Mydriatic nonmydriatic integrated retinal camera kowa. Semiautomatic geographic atrophy segmentation for sdoct.
Fundus autofluorescence faf is a noninvasive retinal imaging modality used in clinical practice to provide a density map of lipofuscin, the predominant ocular fluorophore, in the retinal pigment epithelium. Lipofuscin reveals a previously unseen world of potential disease indicators. Fundus autofluorescence faf, a relatively new imaging modality, focuses on the fluorescent properties of pigments in the retina to generate images that help us view various disease processes from a different perspective. Photoreceptor cells as a source of fundus autofluorescence.
722 105 490 973 1312 328 1175 894 1403 978 1288 950 190 1157 1238 178 1320 1513 1243 267 1557 1191 1397 399 632 347 228 220 521 22 640 7 477