Department of Ophthalmology, University Hospital Jena, Jena, Germany.
Institute for Medical Statistics, Informatics, und Data Sciences, University Hospital Jena, Jena, Germany.
Acta Ophthalmol. 2023 Mar;101(2):e154-e166. doi: 10.1111/aos.15238. Epub 2022 Aug 26.
To observe fundus autofluorescence (FAF) lifetimes and peak emission wavelength (PEW) of drusen with respect to the pathology of the overlying RPE in the follow-up of AMD-patients.
Forty eyes of 38 patients (age: 75.1 ± 7.1 years) with intermediate AMD were included. FAF lifetimes and PEW were recorded by fluorescence lifetime imaging ophthalmoscopy (FLIO). Twenty-six eyes had a follow-up investigation between months 12 and 36, and 10 at months 37-72. AMD progression was retrieved from color fundus photography (CFP) and OCT. Drusen were classified with respect to changes in the overlying RPE into groups no, questionable or faint, and apparent hyperpigmentation based on CFP.
Among the 210 hyperautofluorescent drusen found at baseline, those with hyperpigmentation had longer lifetimes and shorter PEW than those without. Drusen without hyperpigmentation had shorter lifetimes and PEW than neighboring RPE (all p < 0.001) at baseline, but drusen lifetimes increased, and PEW shortened further over follow-up. Eyes, showing AMD progression, had significantly longer FAF lifetimes at baseline than non-progressing eyes: 282 ± 102 ps versus 245 ± 98 ps, p < 0.001 and 365 ± 44 ps vs. 336 ± 48 ps, p = 0.025 for short and long wavelength FLIO channel, respectively.
Depending on hyperpigmentation properties, drusen show lifetimes and PEW different from that of adjacent RPE which change over the natural history of AMD. This difference and change, however, might reflect progressive dysmorphia of the RPE rather than representing fluorescence of drusen material itself. Nevertheless, the observed FAF changes could make FLIO a useful tool for the early detection of AMD progression risk.
观察 AMD 患者随访中与 RPE 上层病理相关的玻璃膜疣（drusen）的荧光寿命和峰值发射波长（PEW）。
纳入 38 名患者（年龄：75.1±7.1 岁）的 40 只眼，这些患者均患有中间型 AMD。荧光寿命成像眼底镜（FLIO）记录荧光寿命和 PEW。26 只眼在 12 至 36 个月之间进行了随访调查，10 只眼在 37 至 72 个月之间进行了随访调查。通过彩色眼底照相（CFP）和 OCT 检索 AMD 进展情况。根据 CFP 中 RPE 上层的变化，将 drusen 分为无、可疑或微弱和明显色素沉着组。
在基线时发现的 210 个高自发荧光 drusen 中，那些有色素沉着的 drusen 的寿命比没有色素沉着的 drusen 长，PEW 比没有色素沉着的 drusen 短。在基线时，没有色素沉着的 drusen 比邻近的 RPE 寿命短，PEW 短（均 P<0.001），但随着随访，drusen 寿命增加，PEW 进一步缩短。与非进展性眼相比，显示 AMD 进展的眼在基线时的 FAF 寿命明显更长：282±102 ps 与 245±98 ps，p<0.001 和 365±44 ps 与 336±48 ps，p=0.025，分别用于短波长和长波长 FLIO 通道。
根据色素沉着的特性，drusen 的寿命和 PEW 与相邻 RPE 不同，并且在 AMD 的自然史中会发生变化。然而，这种差异和变化可能反映了 RPE 的进行性畸形，而不是代表 drusen 物质本身的荧光。尽管如此，观察到的 FAF 变化可能使 FLIO 成为早期检测 AMD 进展风险的有用工具。
