Department of Ophthalmology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
Department of Ophthalmology, Hannover Medical School, Hannover, Germany.
Graefes Arch Clin Exp Ophthalmol. 2024 Sep;262(9):2885-2895. doi: 10.1007/s00417-024-06449-2. Epub 2024 Apr 8.
To investigate the sensitivity of fluorescence lifetime imaging ophthalmoscopy (FLIO) to detect retinal laser spots by comparative analysis with other imaging modalities.
A diode laser with a wavelength of 514 nm was applied with pulse durations of 5.2, 12, 20, and 50 µs. The laser pulse energy was increased so that the visibility of the laser spot by slit-lamp fundus examination (SL) under the irradiator's observation covers from the subvisible to visible range immediately after irradiation. The irradiated areas were then examined by fundus color photography (FC), optical coherence tomography (OCT), fundus autofluorescence (AF), FLIO, and fluorescein angiography (FA). The visibility of a total of over 2200 laser spots was evaluated by two independent researchers, and effective dose (ED) 50 laser pulse energy values were calculated for each imaging modality and compared.
Among examined modalities, FA showed the lowest mean of ED50 energy value and SL the highest, that is, they had the highest and lowest sensitivity to detect retinal pigment epithalium (RPE)-selective laser spots, respectively. FLIO also detected spots significantly more sensitively than SL at most laser pulse durations and was not significantly inferior to FA. AF was also often more sensitive than SL, but the difference was slightly less significant than FLIO.
Considering its high sensitivity in detecting laser spots and previously reported potential of indicating local wound healing and metabolic changes around laser spots, FLIO may be useful as a non-invasive monitoring tool during and after minimally invasive retinal laser treatment.
通过与其他成像方式的比较分析，研究荧光寿命成像眼底镜（FLIO）探测视网膜激光光斑的灵敏度。
采用波长为 514nm 的二极管激光，脉宽分别为 5.2、12、20 和 50µs。激光脉冲能量逐渐增加，使得在辐照器观察下，裂隙灯眼底检查（SL）中激光光斑的可见度从照射后立即的次可见范围增加到可见范围。然后用眼底彩色照相（FC）、光学相干断层扫描（OCT）、眼底自发荧光（AF）、FLIO 和荧光素血管造影（FA）检查照射区域。由两位独立研究人员评估总共超过 2200 个激光光斑的可见度，并计算出每种成像方式的有效剂量（ED）50 激光脉冲能量值并进行比较。
在所检查的方式中，FA 的平均 ED50 能量值最低，SL 最高，这意味着它们对探测视网膜色素上皮（RPE）选择性激光光斑的灵敏度最高和最低。FLIO 在大多数激光脉宽下也比 SL 探测光斑更敏感，且并不明显劣于 FA。AF 也经常比 SL 更敏感，但差异略小于 FLIO。
考虑到其探测激光光斑的高灵敏度，以及之前报道的指示激光光斑周围局部愈合和代谢变化的潜力，FLIO 可能成为微创视网膜激光治疗期间和之后的一种有用的非侵入性监测工具。
