Retinal fluorescence imaging helps identify early functional changes
WAIKOLOA, Hawaii — Fluorescence imaging can be an important tool for early detection of retinal diseases, according to a presentation at Retina 2022.
Rishi P. Singh, MD, said that technologies such as fundus autofluorescence (FAF), fluorescence lifetime imaging ophthalmoscopy (FLIO) and oxidized flavoprotein fluorescence (FPF) provide opportunities to identify cell dysfunction before it occurs.
“What we look at typically, as retina specialists, is really cell death,” he said. “You’re looking at atrophy or anatomical changes, which is obviously the end state, and you want to catch things before they get to that state. Maybe some of these autofluorescence patterns might be helpful at picking up functional changes before they occur in these patients.”
Singh said FAF can be used for several reasons, such as to explain vision loss to patients or to monitor new patients, the area of disturbance or atrophy. It can also be used to make a noninvasive diagnosis, particularly in conditions such as geographic atrophy.
“It’s very easy to figure out and show your patient when you’ve lost vision,” he said.
Additionally, FAF can identify rips in neovascular age-related macular degeneration and help make a diagnosis in diseases such as vitelliform dystrophy.
Singh said FPF and FLIO can be complementary, providing a different benefit.
“It might be indicative of earlier disease before it occurs,” he said. “Looking at some of the dysfunctions may be an encouraging way of finding patients before the final structural damage occurs.”
These technologies have some drawbacks, Singh said. Factors such as media opacity, autofluorescence properties and other ocular structures need to be worked out. Singh said he has done studies in which significant corrections had to be made to account for such factors.
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Singh RP. Retinal fluorescence imaging. Presented at: Retina 2022; Jan. 15-21, 2022; Waikoloa, Hawaii.
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