Clinical applications of fundus autofluorescence in retinal disease

Yung, Madeline; Klufas, Michael A.; Sarraf, David

doi:10.1186/s40942-016-0035-x

Cited by 236Retinal Diseases and TreatmentsRetinal Imaging and AnalysisRetinal Development and Disorders

Clinical applications of fundus autofluorescence in retinal disease

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Yung, Madeline, Klufas, Michael A., Sarraf, David·2016·International Journal of Retina and Vitreous

DOI 10.1186/s40942-016-0035-xPMC PMC5088473

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Abstract

Fundus autofluorescence (FAF) is a non-invasive retinal imaging modality used in clinical practice to provide a density map of lipofuscin, the predominant ocular fluorophore, in the retinal pigment epithelium. Multiple commercially available imaging systems, including the fundus camera, the confocal scanning laser ophthalmoscope, and the ultra-widefield imaging device, are available to the clinician. Each offers unique advantages for evaluating various retinal diseases. The clinical applications of FAF continue to expand. It is now an essential tool for evaluating age related macular degeneration, macular dystrophies, retinitis pigmentosa, white dot syndromes, retinal drug toxicities, and various other retinal disorders. FAF may detect abnormalities beyond those detected on funduscopic exam, fluorescein angiography, or optical coherence tomography, and can be used to elucidate disease pathogenesis, form genotype-phenotype correlations, diagnose and monitor disease, and evaluate novel therapies. Given its ease of use, non-invasive nature, and value in characterizing retinal disease, FAF enjoys increasing clinical relevance. This review summarizes common ocular fluorophores, imaging modalities, and FAF findings for a wide spectrum of retinal disorders.

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A2E cannot be further metabolized and RPE cells are postmitotic, so A2E and related bisretinoids accumulate in the RPE in the form of lipofuscin deposits.
“As A2E can not be further metabolized and as RPE cells are postmitotic, A2E and related bisretinoids accumulate in the RPE in the form of lipofuscin deposits.”
From The Role of Vitamin A in Retinal Diseases (2022) · cites this paper as [75]
The “A2E” section says A2E is enzymatically indigestible and accumulates in RPE lysosomes. The “Lipofuscin” section says bisretinoids are deposited in the RPE as lipofuscin and accumulate with age. Neither section states that RPE cells are postmitotic or identifies that as a reason for accumulation; page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Although abundant lipofuscin accumulation is involved in the aetiology of certain retinal diseases such as AMD, Best disease and ABCA4-retinopathy, it also accumulates at a lower level with age in the RPE of healthy eyes.
“Although abundant lipofuscin accumulation is involved in the aetiology of certain retinal diseases (e.g., AMD, Best disease and ABCA4-retinopathy), it accumulates at a lower level also with age in the RPE of healthy eyes [9,72,73,74,75].”
From The Role of Vitamin A in Retinal Diseases (2022) · cites this paper as [75]
The Lipofuscin section (page unavailable) says lipofuscin accumulates in RPE lysosomes with age and increases in AMD, Best disease, and Stargardt disease, which is commonly associated with ABCA4 mutations. It does not establish that lipofuscin accumulation causes those diseases; the A2E section describes its role in retinal damage as uncertain. The age-related accumulation and disease association are supported, but the aetiological claim is stronger than this source warrants. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Lipofuscin compromises the function and viability of RPE cells and ultimately results in photoreceptor degeneration and a loss of vision.
“Lipofuscin is an autofluorescent cellular waste product that compromises the function and viability of RPE cells and ultimately results in photoreceptor degeneration and a loss of vision [54,69,73,74,75].”
From The Role of Vitamin A in Retinal Diseases (2022) · cites this paper as [75]
The Lipofuscin section identifies lipofuscin as an autofluorescent mixture that accumulates in RPE cells. The A2E section reports toxic effects of a lipofuscin component on RPE cells in vitro, but also says its role in retinal damage is uncertain. It does not establish that lipofuscin ultimately causes photoreceptor degeneration and vision loss. Page numbers are unavailable in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measured

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[52]Park SP Siringo FS Pensec N Comparison of fundus autofluorescence between fundus camera and confocal scanning laser ophthalmoscope-based systems Ophthalmic Surgery Lasers Imaging Retina 2013 44 6 536 543 10.3928/23258160-20131105-04 PMC4405534 24221461 · DOI

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ACUTE IDIOPATHIC MACULOPATHY
Rošar, A. P., Casalino, G., Cozzi, M., Pellegrini, M., Bottoni, F., Dell'Arti, L., Lavrič, A., Umek, L., Petrovic, M. G., Pavesio, C. E., et al. (2021) · Retina · doi:10.1097/iae.0000000000003247 · Cited by 8 · see citing works

Authors: Yung, M., Klufas, M. A., & Sarraf, D.
Affiliations: University of California, Los Angeles (US)
Corresponding author: Sarraf, David
ORCID: Yung, Madeline
Klufas, Michael A.
Sarraf, David
Venue: International Journal of Retina and Vitreous
Publisher: Springer Science and Business Media LLC
Published: 2016-04-08
Volume: 2
Issue: 1
Pages: 12-12
ISSN: 2056-9920 (ISSN-L)
DOI: 10.1186/s40942-016-0035-x
PMC: PMC5088473
OpenAlex: W2329521208
Cited by: 236
References: 198
Citations by year: 2026: 15 · 2025: 23 · 2024: 22 · 2023: 20 · 2022: 29 · 2021: 40 · 2020: 31 · 2019: 24 · 2018: 22 · 2017: 8 · 2016: 1 · 2015: 1
FWCI: 3.58
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: International Journal of Retina and Vitreous (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Funders: Regeneron Pharmaceuticals
Genentech
Topics: Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinal Development and Disorders
Keywords: fundus autofluorescence, lipofuscin, retinal pigment epithelium, age-related macular degeneration, macular dystrophy, retinitis pigmentosa, white dot syndromes, ultra-widefield imaging, confocal scanning laser ophthalmoscopy, genotype-phenotype correlation

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