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Retinal fluorescence lifetimes can characterize Stargardt’s
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The changes in retinal fluorescence lifetimes over time in Stargardt’s disease may provide valuable information in predicting disease progression and may be used to evaluate therapeutic effects in clinical trials, according to researchers in Investigative Ophthalmology & Visual Science.
Researchers analyzed fluorescence lifetime imaging ophthalmoscopy data from 16 patients with Stargardt’s disease (STGD) and 15 age-matched controls using a custom fluorescence lifetime imaging ophthalmoscope (FLIO) based on a Heidelberg Engineering Spectralis system developed by the University of Bern, Switzerland. A 1-year follow-up was performed in eight STGD patients.
Autofluorescence was excited with a 473-nm laser, and decay times were measured in a short and long spectral channel.
Patients with STGD showed autofluorescence lifetimes within yellow flecks (446 ps) compared with 297 ps in unaffected areas, according to researchers.
All 16 patients with STGD showed typical clinical features of STGD, with well-defined hyperautofluorescent flecks distributed around the macular center, spreading toward the periphery.
Stepwise forward regression analysis showed that the diagnosis of STGD and age significantly added to the ability of the equation to predict lifetimes in the short spectral channel or long spectral channel.
“Whereas areas without flecks and atrophy secondary to STGD featured lifetime values comparable to age-matched healthy controls, both hyperfluorescent flecks and hypofluorescent atrophic lesions showed either shorter or longer lifetime values,” researchers wrote.
Within STGD patients, the researchers found a vast range of fluorescence lifetimes with STGD lesions in FLIO measurements.
The long fluorescence may indicate a major dysfunction of the underlying retinal pigment epithelium due to accumulation of lipofuscin and insufficient degradation, according to the researchers.
The short lifetime lesions may turn into lesions displaying the characteristic long lifetimes, they added.
“Probably retinal fluorescence indicates an equilibrium of short and long decay components that is not changed by equal increase of the components. On the other hand, in areas with strongly increased autofluorescence intensity, lifetimes can be shifted toward shorter or longer lifetimes depending on the predominant fluorophore of the lesions,” researchers wrote.
They concluded that analysis of retinal fluorescence lifetimes can be used to characterize and differentiate hyperfluorescent lesions and hypofluorescent atrophic areas in STGD.
Disclosure: Dysli received funding from Heidelberg Engineering. Please see the full study for all remaining authors relevant financial disclosures.
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