Retinal flavoprotein fluorescence could be new biomarker of AMD stage, progression
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Mitochondrial flavoprotein fluorescence may possibly serve as an indicator of age-related macular degeneration stage, helping to detect early disease and offering insights on how and when to treat patients, according to a study.
Oxidative stress-induced mitochondrial dysfunction is a well-known component of the pathophysiology of AMD. Flavoproteins serve an essential role in normal mitochondrial function. When oxidized, under blue light stimulation they emit a green autofluorescence signal that could potentially be used as a biomarker of mitochondrial dysfunction.
“Until recently, mitochondria, the powerhouse of cells, were not visible and quantifiable in vivo,” Rishi P. Singh, MD, principal investigator of the study, told Healio/OSN. “Advances in retinal imaging using a modified fundus camera with excitation and barrier filters have identified fluorescence, which can occur in one of the flavoproteins present with mitochondria.”
Using an investigative device (OcuMet Beacon, OcuSciences) for flavoprotein fluorescence (FPF) imaging, FPF intensity and heterogeneity were measured in 228 eyes with various stages of AMD and 228 control eyes.
Multivariate regression analysis of FPF intensity showed that intermediate AMD, neovascular AMD and geographic atrophy (GA) were correlated with significant increase of FPF intensity and heterogeneity. Both values were also significantly correlated with decreased best corrected visual acuity. Variables that predict AMD progression, such as age, sex and smoking, and increased FPF intensity were associated.
Long-term trials are needed to evaluate the predictive role of FPF imaging over time. However, the findings of this study suggest that FPF may be of utility in the clinical setting and has the potential to provide “a better understanding of the underlying pathophysiology of AMD, particularly the role of mitochondrial dysfunction in AMD and its progression,” the authors said.
Further research on retinal flavoprotein fluorescence is underway.
“Our recent studies have demonstrated correlations of increased flavoprotein fluorescence with diabetic retinopathy severity as well as AMD. In addition, our research has identified changes following anti-VEGF use, suggesting that FPF could be also a potential biomarker for treatment response. Future studies will expand upon this direct correlation and how it might predict visual acuity improvements,” Singh said.
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Muste JC, et al. Ophthalmic Surg Lasers Imaging Retina. 2023;doi:10.3928/23258160-20221214-03.
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