Leitão Guerra Ricardo Luz, Leitão Guerra Cezar Luz, Meirelles Mariana Gouveia Bastos, Barbosa Gabriel Castilho Sandoval, Novais Eduardo Amorim, Badaró Emmerson, Lucatto Luiz Filipe Adami, Roisman Luiz
Department of Ophthalmology Leitão Guerra - Oftalmologia (Salvador, Brazil), Rua Rio de São Pedro, no 256 Graça, CEP 40.150-350, Salvador, (BA), Brazil; Orbit Ophthalmo Learning, Rua Rio de São Pedro, no 256 Graça, CEP 40.150-350, Salvador, (BA), Brazil.
Department of Ophthalmology Leitão Guerra - Oftalmologia (Salvador, Brazil), Rua Rio de São Pedro, no 256 Graça, CEP 40.150-350, Salvador, (BA), Brazil.
Prog Retin Eye Res. 2025 Mar;105:101326. doi: 10.1016/j.preteyeres.2024.101326. Epub 2025 Jan 3.
Blue light reflectance (BLR) imaging offers a non-invasive, cost-effective method for evaluating retinal structures by analyzing the reflectance and absorption characteristics of the inner retinal layers. By leveraging blue light's interaction with retinal tissues, BLR enhances visualization beyond the retinal nerve fiber layer, improving detection of structures such as the outer plexiform layer and macular pigment. Its diagnostic utility has been demonstrated in distinct retinal conditions, including hyperreflectance in early macular telangiectasia, hyporeflectance in non-perfused areas indicative of ischemia, identification of pseudodrusen patterns (notably the ribbon type), and detection of peripheral retinal tears and degenerative retinoschisis in eyes with reduced retinal pigment epithelial pigmentation. Best practices for image acquisition and interpretation are discussed, emphasizing standardization to minimize variability. Common artifacts and mitigation strategies are also addressed, ensuring image reliability. BLR's clinical utility, limitations, and future research directions are highlighted, particularly its potential in automated image analysis and quantitative assessment. Different BLR acquisition methods, such as fundus photography, confocal scanning laser ophthalmoscopy, and broad line fundus imaging, are evaluated for their respective advantages and limitations. As research advances, BLR's integration into multimodal workflows is expected to improve early detection and precise monitoring of retinal diseases.
蓝光反射率（BLR）成像提供了一种非侵入性、经济高效的方法，通过分析视网膜内层的反射率和吸收特性来评估视网膜结构。通过利用蓝光与视网膜组织的相互作用，BLR增强了视网膜神经纤维层以外结构的可视化，改善了对外网状层和黄斑色素等结构的检测。其诊断效用已在不同的视网膜疾病中得到证实，包括早期黄斑毛细血管扩张症中的高反射、指示缺血的非灌注区域中的低反射、假玻璃膜疣模式（特别是带状类型）的识别，以及视网膜色素上皮色素减少的眼睛中周边视网膜裂孔和视网膜变性性劈裂的检测。文中讨论了图像采集和解读的最佳实践，强调标准化以尽量减少变异性。还讨论了常见伪像及缓解策略，以确保图像可靠性。重点介绍了BLR的临床效用、局限性和未来研究方向，特别是其在自动图像分析和定量评估方面的潜力。评估了不同的BLR采集方法，如眼底摄影、共焦扫描激光眼底镜检查和宽线眼底成像的各自优缺点。随着研究的进展，预计BLR整合到多模态工作流程中将改善视网膜疾病的早期检测和精确监测。
