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Longitudinal Assessment of Progressive Retinal Pigment Epithelium Disruption in a 26 Year Old A MultiSpectral Imaging Case Study
摘要： Background: Progressive retinal pigment epithelium (RPE) disruption in the absence of drusen or visual disturbances in young people is rarely reported in the literature, except for cases of juvenile macular degenerative diseases, pattern dystrophies or white dot syndromes. In age-related macular degeneration (AMD), RPE disruption typically does not become manifest clinically before age 55. This case report presents a young, healthy 26 year old Caucasian male with asymptomatic progressive RPE disruption in the absence of drusen, as detected by multi-spectral imaging (MSI) technology. Methods: A 26 year old Caucasian male was followed for progressive changes in RPE atrophy and melanin clumping over three visits in a three year period. His dilated fundus examination, fundus photography and optical coherence tomography were within normal limits. Long wavelength MSI revealed progressive RPE changes in the form of RPE atrophy and melanin clumping. MSI fundus auto-fluorescence (FAF) showed corresponding hyperautofluorescence and hypoautofluorescence in the left. Findings: Macular RPE changes can result from phototoxic effects and vary by ethnicity. Functional biomarkers to determine the risk of future vision loss with AMD are frequently sought and include complement factor H and Age-Related Maculopathy Susceptibility 2. FAF, for example is highly indicative of RPE dysfunction and progression. Long wavelength MSI, 620 nm to 740 nm, enhances visualization of the RPE, more specifically atrophy and melanin clumping, which may be indicative of asymptomatic progressive early AMD or retinal dystrophies. Conclusion: This case shows a longitudinal example of progressive RPE disruption in a 26 year old male. This is only one example, but multiple cases of RPE disruption in young people exist. Using MSI to further investigate RPE disruption and progression in a young population may provide a potential biomarker for early AMD, photo toxicity or other retinal dystrophies and degenerations.
关键词： Retinal Pigment Epithelium,Fundus Autofluorescence,Age-related Macular Degeneration,Multi-Spectral Imaging,Progressive retinal pigment epithelium disruption
更新于2025-09-11 14:15:04
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New Interpretation of Multimodality Fundus Imaging for Retinal Cavernous Hemangioma
摘要： Objective: The aim of this study was to investigate the multimodality imaging features of retinal cavernous hemangiomas (RCHs). Materials and Methods: The clinical data of three patients with RCH were reviewed and the imaging findings were analyzed. Results: The color photographs of the fundus showed bead-like vesicles in the retina. Some vesicles showed plasma erythrocyte separation—with plasma on the top and erythrocytes at the bottom—which was consistently detected as high spontaneous fluorescence on fundus fluorescence angiography. Other vesicles were surrounded by thick walls and fibrous tissue, showing high spontaneous fluorescence, although they did not show any changes on fluorescence angiography. Optical coherence tomography (OCT) could not discriminate the different characteristics of the vesicles, but could clearly discriminate the appearance of the vesicles and their location on the retina, as well as other structural features. Conclusions: Fundus color photography, fundus fluorescein angiography, and OCT can aid in acquiring a better understanding of the structural features of cavernous hemangioma and its relationship with retinal vessels.
关键词： fluorescein angiography,fundus color photography,Fundus autofluorescence,Retinal cavernous hemangioma,OCT
更新于2025-09-10 09:29:36
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Visible-light optical coherence tomography-based multimodal system for quantitative fundus autofluorescence imaging
摘要： Fundus autofluorescence (FAF) imaging is commonly used in ophthalmic clinics for diagnosis and monitoring of retinal diseases. Lipofuscin in the retinal pigment epithelium (RPE), with A2E as its most abundant component and a visual cycle by-product, is the major fluorophore of FAF. Lipofuscin accumulates with age and is implicated in degenerative retinal diseases. The amount of lipofuscin in RPE can be assessed by quantitative measurement of FAF. However, the currently available FAF imaging technologies are not capable of quantifying the absolute intensity of FAF, which is essential for comparing images from different individuals, and from the same individual over time. One major technical difficulty is to compensate the signal attenuation by ocular media anterior to the RPE (pre-RPE media). FAF intensity is also influenced by fluctuations in imaging conditions such as illumination power and detector sensitivity, all of which need to be compensated. In this review, we present the concept and research progress of using visible-light optical coherence tomography-based simultaneous multimodal retinal imaging to compensate signal attenuation by pre-RPE media and the influence of parameters of the acquisition system for accurate measurement of FAF intensities.
关键词： fundus autofluorescence imaging,multimodal imaging,retinal pigment epithelium lipofuscin,Visible-light optical coherence tomography,retinal imaging,fluorescence quantification
更新于2025-09-09 09:28:46
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Fluorescence Lifetime Imaging in Retinal Artery Occlusion
摘要： Fluorescence lifetime imaging ophthalmoscopy is a technique to measure decay times of endogenous retinal fluorophores. The purpose of this study was to investigate fluorescence lifetimes in eyes with central and branch retinal artery occlusion. Twenty-four patients with central or branch retinal artery occlusion were included in this study. The contralateral unaffected fellow eye was used as control. Measurements were performed using a fluorescence lifetime imaging ophthalmoscope based on a HRA Spectralis system. Fluorescence excitation wavelength was 473 nm, and mean lifetimes were measured in a short (498–560 nm) and in a long (560–720 nm) spectral channel. Fluorescence lifetimes in the area of retinal artery occlusion were measured and compared to corresponding areas in contralateral unaffected eyes. Additionally, findings were correlated to optical coherence tomography measurements. Retinal lifetime images of 24 patients with retinal artery occlusion were analyzed. Mean retinal fluorescence lifetimes were prolonged by 50% in the short and 20% in the long spectral channel in ischemic retinal areas up to 3 days after retinal artery occlusion compared to the contralateral unaffected eyes. In the postacute disease stage there was no difference between the lifetimes of affected areas and unaffected fellow eyes. Retinal artery occlusion leads to significantly longer fluorescence lifetimes of the retina in the acute phase and may serve as a useful indicator for acute ischemic retinal damage.
关键词： retinal artery occlusion,branch retinal artery occlusion,CRAO,ischemia,ophthalmic imaging,fundus autofluorescence,BRAO,central retinal artery occlusion,fluorescence lifetimes
更新于2025-09-09 09:28:46
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Autofluorescence Lifetimes in Patients With Choroideremia Identify Photoreceptors in Areas With Retinal Pigment Epithelium Atrophy
摘要： The purpose of this study was to investigate fundus autofluorescence lifetimes in patients with choroideremia and to identify tissue-specific lifetime characteristics and potential prognostic markers. Autofluorescence lifetimes of the retina were measured in two spectral channels (498–560 nm and 560–720 nm) in patients with choroideremia and age-matched healthy controls. Furthermore, autofluorescence intensities and spectral-domain optical coherence tomography (OCT) data were acquired and compared to fundus autofluorescence lifetime data. Sixteen eyes from 8 patients with advanced choroideremia (mean 6 SD age, 55 6 13 years) were included in this study and compared with 10 age-matched healthy participants. Whereas fundus autofluorescence intensity measurement identified areas of remaining retinal pigment epithelium (RPE), autofluorescence lifetime maps identified areas with remaining photoreceptor layers in OCT but RPE atrophy. In these areas, mean (6SEM) lifetimes were 567 6 59 ps in the short and 603 6 49 ps in the long spectral channels (+98% and +88% compared to controls). In areas of combined RPE atrophy and loss of photoreceptors, autofluorescence lifetimes were significantly prolonged by 1116 6 63 ps (+364%) in the short and by 915 6 52 ps (+270%) in the long spectral channels compared with controls. Because autofluorescence lifetimes identify areas of remaining photoreceptors in the absence of RPE, this imaging modality may be useful to monitor disease progression in the natural course of disease and in context of potential future therapeutic interventions.
关键词： choroideremia,retinal imaging,fundus autofluorescence,FLIO,fluorescence lifetimes,retinal dystrophies
更新于2025-09-09 09:28:46
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Progression of retinitis pigmentosa on multimodal imaging: the PREP‐1 study
摘要： Importance: It is important to establish reliable outcome measures to detect progression in retinitis pigmentosa (RP). Background: To evaluate progression of RP using multimodal imaging, including spectral-domain optical coherence tomography (SD-OCT), fundus autofluorescence (FAF) and microperimetry (MP). Design: Retrospective longitudinal study at a tertiary teaching hospital. Participants: 205 eyes of 106 patients with RP with 1-5 years of follow-up. Methods: Demographics and visual acuity (VA) were recorded, and each modality was graded at baseline and every annual follow-up. SD-OCT was graded for the width of ellipsoid zone (EZ), FAF was graded for the diameter and area of the hyperautofluorescent ring (if present), and MP was graded for mean, central and paracentral sensitivity. Spearman’s correlation was used to measure correlations at baseline. Mixed effects models were used to estimate the annual change of each parameter, adjusted for disease duration. Main outcome measures: Rate of progression. Results: The median VA at baseline was 75 letters and was positively correlated with mean and central sensitivity (r: 0.372 and 0.394; p=0.01 for both). All parameters (except paracentral sensitivity) were strongly correlated with each other (r: 0.673-0.991; p<0.001 for all). The annual rates of change for each parameter were as follows: VA, -2.3 letters (p<0.001); EZ, -151um (p<0.001); ring diameter, -132um (p<0.001); ring area, -0.4mm2 (p<0.001); mean sensitivity, -0.3 dB (p<0.001); central sensitivity, -0.7 dB (p<0.001); paracentral sensitivity, -0.4 dB (p<0.001). Conclusion and relevance: Structural and functional measures are well correlated in RP and can reliable measure disease progression within the course of a year.
关键词： Optical Coherence Tomography,Multimodal Imaging,Microperimetry,Fundus Autofluorescence,Disease Progression
更新于2025-09-04 15:30:14