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Ocular fundus auto-fluorescence observations at different wavelengths in patients with age-related macular degeneration and diabetic retinopathy

  • Retinal Disorders
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Abstract

Background

Post-translational protein modification by lipid peroxidation products or glycation is a feature of aging as well as pathologic processes in postmitotic cells at the ocular fundus exposed to an oxidative environment. The accumulation of modified proteins such as those found in lipofuscin and advanced glycation end products (AGEs) contribute greatly to the fundus auto-fluorescence. The distinct fluorescence spectra of lipofuscin and AGE enable their differentiation in multispectral fundus fluorescence imaging.

Method

A dual-centre consecutive case series of 78 pseudo-phacic patients is reported. Digital colour fundus photographs as well as auto-fluorescence images were taken from 33 patients with age related macular degeneration (AMD), 13 patients with diabetic retinopathy (RD), or from 32 cases without pathologic findings (controls). Fluorescence was excited at 475–515 nm or 476–604 nm and recorded in the emission bands 530–675 nm or 675–715 nm, respectively. Fluorescence images excited at 475–515 nm were taken by a colour CCD-camera (colour-fluorescence imaging) enabling the separate recording of green and red fluorescence. The ratio of green versus red fluorescence was calculated within a representative region of each image.

Results

The 530–675 nm auto-fluorescence in AMD patients was dominated by the red emission (green vs. red ratio, g/r = 0.861). In comparison, the fluorescence of the diabetics was green-shifted (g/r = 0.946; controls: g/r = 0.869). Atrophic areas (geographic atrophy, laser scars) showed massive hypo-fluorescence in both emission bands. Hyper-fluorescent drusen and exudates, unobtrusive in the colour fundus images as well as in the fluorescence images with emission >667 nm, showed an impressive green-shift in the colour-fluorescence image.

Conclusions

Lipofuscin is the dominant fluorophore at long wavelengths (>675 nm or red channel of the colour fluorescence image). In the green spectral region, we found an additional emission of collagen and elastin (optic disc, sclera) as well as deposits in drusen and exudates. The green shift of the auto-fluorescence in RD may be a hint of increased AGE concentrations.

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Acknowledgements

The authors gratefully acknowledge the gift of histological sections from a donor eye of an AMD patient by Dr. Elizabeth Gaillard from Northern Illinois University at DeKalb.

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Authors and Affiliations

  1. Department of Ophthalmoloy, University of Jena, Bachstr. 18, 07740, Jena, Germany

    Martin Hammer, Ekkehart Königsdörffer, Christiane Liebermann, Dietrich Schweitzer & Jürgen Strobel

  2. Department of Ophthalmoloy, University of Regensburg, Franz-Josef Strauss-Allee 11, 93053, Regensburg, Germany

    Carsten Framme & Günter Schuch

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  1. Martin Hammer
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  2. Ekkehart Königsdörffer
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Correspondence to Martin Hammer.

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None of the authors has any financial relationship. All primary data are under full control of the authors and may be reviewed upon request.

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Hammer, M., Königsdörffer, E., Liebermann, C. et al. Ocular fundus auto-fluorescence observations at different wavelengths in patients with age-related macular degeneration and diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 246, 105–114 (2008). https://doi.org/10.1007/s00417-007-0639-9

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  • DOI: https://doi.org/10.1007/s00417-007-0639-9

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