Kellner Simone, Weinitz Silke, Farmand Ghazaleh, Kellner Ulrich
Rare Retinal Disease Center, Augen Zentrum Siegburg, MVZ Augenärztliches Diagnostik- und Therapiecentrum Siegburg GmbH, 53721 Siegburg, Germany.
RetinaScience, 53192 Bonn, Germany.
J Clin Med. 2024 Nov 15;13(22):6886. doi: 10.3390/jcm13226886.
Near-infrared autofluorescence (NIA) is a non-invasive retinal imaging technique used to examine the retinal pigment epithelium (RPE) based on the autofluorescence of melanin. Melanin has several functions within RPE cells. It serves as a protective antioxidative factor and is involved in the phagocytosis of photoreceptor outer segments. Disorders affecting the photoreceptor-RPE complex result in alterations of RPE cells which are detectable by alterations of NIA. NIA allows us to detect early alterations in various chorioretinal disorders, frequently before they are ophthalmoscopically visible and often prior to alterations in lipofuscin-associated fundus autofluorescence (FAF) or optical coherence tomography (OCT). Although NIA and FAF relate to disorders affecting the RPE, the findings for both imaging methods differ and the area involved has been demonstrated to be larger in NIA compared to FAF in several disorders, especially inherited retinal dystrophies (IRDs), indicating that NIA detects earlier alterations compared to FAF. Foveal alterations can be much more easily detected using NIA compared to FAF. A reduced subfoveal NIA intensity is the earliest sign of autosomal dominant Best disease, when FAF and OCT are still normal. In other IRDs, a preserved subfoveal NIA intensity is associated with good visual acuity. So far, the current knowledge on NIA in IRD has been presented in multiple separate publications but has not been summarized in an overview. This review presents the current knowledge on NIA in IRD and demonstrates NIA biomarkers.
近红外自发荧光（NIA）是一种基于黑色素自发荧光来检查视网膜色素上皮（RPE）的非侵入性视网膜成像技术。黑色素在RPE细胞内具有多种功能。它作为一种保护性抗氧化因子，并参与光感受器外段的吞噬作用。影响光感受器-RPE复合体的疾病会导致RPE细胞发生改变，这些改变可通过NIA的变化检测到。NIA使我们能够在各种脉络膜视网膜疾病的早期改变出现时就进行检测，通常在眼底镜可见之前，而且常常在脂褐素相关的眼底自发荧光（FAF）或光学相干断层扫描（OCT）出现改变之前。尽管NIA和FAF都与影响RPE的疾病有关，但两种成像方法的结果不同，并且在几种疾病中，尤其是遗传性视网膜营养不良（IRD），已证明NIA所涉及的区域比FAF更大，这表明与FAF相比，NIA能检测到更早的改变。与FAF相比，使用NIA更容易检测到黄斑改变。当FAF和OCT仍正常时，黄斑下NIA强度降低是常染色体显性Best病的最早迹象。在其他IRD中，黄斑下NIA强度保持正常与良好的视力相关。到目前为止，关于IRD中NIA的现有知识已在多个单独的出版物中呈现，但尚未进行综述总结。本综述介绍了关于IRD中NIA的现有知识，并展示了NIA生物标志物。
