FUNDUS AUTOFLUORESCENCE AND DYE ANGIOGRAPHIES

Fatma Büşra Altaş

Ankara Etlik City Hospital, Department of Ophthalmology, Ankara, Türkiye

Altaş FB. Fundus Autofluorescence and Dye Angiographies. In: Çıtırık M, Şekeryapan Gediz B, editors. Age-Related Macular Degeneration: Current Investigations and Treatments. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.31-46.

ABSTRACT

Age related macular degeneration (AMD) is a disease characterized by the progressive degeneration of the retinal pigment epithelium (RPE) and choriocapillaris. Various imaging techniques are utilized to assess the pathogenesis and progression of the disease. Fundus autofluorescence (FAF) aids in identifying atrophic areas by reflecting the metabolic status of the RPE. Fundus fluorescein angiography (FFA) evaluates choroidal and retinal circulation, revealing drusen, neovascularization, and leakage areas. Indocyanine green angiography (ICGA) provides enhanced visualization of choroidal circulation, playing a crucial role in diagnosing subtypes such as polypoidal choroidal vasculopathy. The combination of these methods facilitates a more accurate classification of AMD and the determination of appropriate treatment approaches.

Keywords: Fundus autofluorescence; Fundus fluorescein angiography; Indocyanine green angiography; Age related macular degeneration

Referanslar

  1. Marmorstein AD, Marmorstein LY, Sakaguchi H, Hollyfield JG. Spectral profiling of autofluorescence associated with lipofuscin, Bruch's Membrane, and sub-RPE deposits in normal and AMD eyes. Invest Ophthalmol Vis Sci. 2002 Jul;43(7):2435-41. PMID: 12091448. [Link]
  2. Rothenbuehler SP, Wolf-Schnurrbusch UE, Wolf S. Macular pigment density at the site of altered fundus autofluorescence. Graefes Arch Clin Exp Ophthalmol. 2011 Apr;249(4):499- 504. Epub 2010 Sep 28. [Crossref]  [PubMed]
  3. Bellmann C, Rubin GS, Kabanarou SA, Bird AC, Fitzke FW. Fundus autofluorescence imaging compared with different confocal scanning laser ophthalmoscopes. Br J Ophthalmol. 2003 Nov;87(11):1381-6. [Crossref]  [PubMed]  [PMC]
  4. Pfau M, Goerdt L, Schmitz-Valckenberg S, Mauschitz MM, Mishra DK, Holz FG, et al. Green-Light Autofluorescence Versus Combined Blue-Light Autofluorescence and Near-Infrared Reflectance Imaging in Geographic Atrophy Secondary to Age-Related Macular Degeneration. Invest Ophthalmol Vis Sci. 2017 May 1;58(6):BIO121-BIO130. Erratum in: Invest Ophthalmol Vis Sci. 2018 Feb 1;59(2):674. [Crossref]  [PubMed]
  5. Gu X, Neric NJ, Crabb JS, Crabb JW, Bhattacharya SK, Rayborn ME, et al. Age-related changes in the retinal pigment epithelium (RPE). PLoS One. 2012;7(6):e38673. Epub 2012 Jun 11. [Crossref]  [PubMed]  [PMC]
  6. Gliem M, Müller PL, Finger RP, McGuinness MB, Holz FG, Charbel Issa P. Quantitative Fundus Autofluorescence in Early and Intermediate Age-Related Macular Degeneration. JAMA Ophthalmol. 2016 Jul 1;134(7):817-24. [Crossref]  [PubMed]
  7. Borrelli E, Lei J, Balasubramanian S, Uji A, Cozzi M, Sarao V, Lanzetta P, Staurenghi G, Sadda SR. Green emission fluorophores in eyes with atrophic age-related macular degeneration: a colour fundus autofluorescence pilot study. Br J Ophthalmol. 2018 Jun;102(6):827-832. Epub 2017 Sep 25. [Crossref]  [PubMed]
  8. Johnson RN, Fu AF, McDonald HR, Jumper M, Ai E, Cunningham ET, Lujan BJ. Fluorescein Angiography. Basic Principles and Interpretation. 5th ed. London: Elsevier Saunders; 2013. P.1-50. [Link]
  9. Staurenghi G, Bottoni F, Giani A. Clinical applications of diagnostic indocyanine green angiography. 5th ed. Retina. London: Elsevier Saunders; 2013. p. 51-81. [Crossref]
  10. Desmettre T, Cohen SY, Devoisselle JM, Gaudric A. Current uses and indications for indocyanine green angiography. J Fr Ophtalmol. 2011 Oct;34(8):568-82. French. Epub 2011 Sep 9. [Crossref]  [PubMed]  [PMC]
  11. Ferris FL 3rd, Wilkinson CP, Bird A, Chakravarthy U, Chew E, Csaky K, et al; Beckman Initiative for Macular Research Classification Committee. Clinical classification of age-related macular degeneration. Ophthalmology. 2013 Apr;120(4):844-51. Epub 2013 Jan 16. [Crossref]  [PubMed]  [PMC]
  12. Bindewald A, Bird AC, Dandekar SS, Dolar-Szczasny J, Dreyhaupt J, Fitzke FW,et al. Classification of fundus autofluorescence patterns in early age-related macular disease. Invest Ophthalmol Vis Sci. 2005 Sep;46(9):3309-14. [Crossref]  [PubMed]
  13. Batioğlu F, Demirel S, Ozmert E, Oguz YG, Ozyol P. Autofluorescence patterns as a predictive factor for neovascularization. Optom Vis Sci. 2014 Aug;91(8):950-5. [Crossref]  [PubMed]
  14. Witmer MT, Kozbial A, Daniel S, Kiss S. Peripheral autofluorescence findings in age-related macular degeneration. Acta Ophthalmol. 2012 Sep;90(6):e428-33. Epub 2012 May 11. [Crossref]  [PubMed]
  15. Writing Committee for the OPTOS PEripheral RetinA (OPERA) study (Ancillary Study of Age-Related Eye Disease Study 2); Domalpally A, Clemons TE, Danis RP, Sadda SR, Cukras CA, Toth CA, et al. Peripheral Retinal Changes Associated with Age-Related Macular Degeneration in the Age-Related Eye Disease Study 2: Age-Related Eye Disease Study 2 Report Number 12 by the Age-Related Eye Disease Study 2 Optos PEripheral RetinA (OPERA) Study Research Group. Ophthalmology. 2017 Apr;124(4):479-487. Epub 2017 Jan 12. [Crossref]  [PubMed]
  16. Reznicek L, Wasfy T, Stumpf C, Kampik A, Ulbig M, Neubauer AS, Kernt M. Peripheral fundus autofluorescence is increased in age-related macular degeneration. Invest Ophthalmol Vis Sci. 2012 Apr 24;53(4):2193-8. [Crossref]  [PubMed]
  17. Küçükiba K, Erol N, Bilgin M. Yaşa Bağlı Makula Dejenerasyonu Olan Hastalarda Periferal Retina kayıtlarının Ultra-geniş Açılı Fundus Otofloresans Görüntüleri ile Değerlendirilmesi. Türk J Oftalmol. 2020 Oca;50(1):6-14. [Link]
  18. Tan CS, Heussen F, Sadda SR. Peripheral autofluorescence and clinical findings in neovascular and non-neovascular age-related macular degeneration. Ophthalmology. 2013 Jun;120(6):1271-7. Epub 2013 Feb 22. [Crossref]  [PubMed]  [PMC]
  19. Battaglia Parodi M, Iacono P, Papayannis A, Alto G, Buzzotta A, Arrigo A, Cicinelli MV, Bandello F. Near-infrared fundus autofluorescence in early age-related macular degeneration. Eur J Ophthalmol. 2020 Nov;30(6):1448-1453. Epub 2019 Oct 29. [Crossref]  [PubMed]
  20. Pilotto E, Vujosevic S, Melis R, Convento E, Sportiello P, Alemany-Rubio E, et al. Short wavelength fundus autofluorescence versus near-infrared fundus autofluorescence, with microperimetric correspondence, in patients with geographic atrophy due to age-related macular degeneration. Br J Ophthalmol. 2011 Aug;95(8):1140-4. Epub 2010 Oct 24. [Crossref]  [PubMed]
  21. Karampelas M, Malamos P, Petrou P, Georgalas I, Papaconstantinou D, Brouzas D. Retinal Pigment Epithelial Detachment in Age-Related Macular Degeneration. Ophthalmol Ther. 2020 Dec;9(4):739-756. Epub 2020 Aug 18. [Crossref]  [PubMed]  [PMC]
  22. Peng ET, Adrean SD. Geographic Atrophy after Reabsorption of Pigment Epithelial Detachment (GARPED) study. BMC Ophthalmol. 2023 May 30;23(1):242. [Crossref]  [PubMed]  [PMC]
  23. Wightman AJ, Guymer RH. Reticular pseudodrusen: current understanding. Clin Exp Optom. 2019 Sep;102(5):455-462. Epub 2018 Oct 8. [Crossref]  [PubMed]
  24. Wu Z, Fletcher EL, Kumar H, Greferath U, Guymer RH. Reticular pseudodrusen: A critical phenotype in age-related macular degeneration. Prog Retin Eye Res. 2022 May;88:101017. Epub 2021 Nov 6. [Crossref]  [PubMed]
  25. Holz FG, Steinberg JS, Göbel A, Fleckenstein M, Schmitz-Valckenberg S. Fundus autofluorescence imaging in dry AMD: 2014 Jules Gonin lecture of the Retina Research Foundation. Graefes Arch Clin Exp Ophthalmol. 2015 Jan;253(1):7-16. Epub 2014 Nov 19. [Crossref]  [PubMed]
  26. Batıoğlu F, Demirel S, Özmert E. Fundus autofluorescence imaging in age-related macular degeneration. Semin Ophthalmol. 2015 Jan;30(1):65-73. Epub 2013 Aug 16. [Crossref]  [PubMed]
  27. Fleckenstein M, Mitchell P, Freund KB, Sadda S, Holz FG, Brittain C, Henry EC, Ferrara D. The Progression of Geographic Atrophy Secondary to Age-Related Macular Degeneration. Ophthalmology. 2018 Mar;125(3):369-390. Epub 2017 Oct 27. [Crossref]  [PubMed]
  28. Macular Photocoagulation Study Group. Laser photocoagulation of subfoveal neovascular lesions in age-related macular degeneration. Results of a randomized clinical trial. Arch Ophthalmol. 1991 Sep;109(9):1220-31. [Crossref]  [PubMed]
  29. Grossniklaus HE, Gass JD. Clinicopathologic correlations of surgically excised type 1 and type 2 submacular choroidal neovascular membranes. Am J Ophthalmol. 1998 Jul;126(1):59-69. [Crossref]  [PubMed]
  30. Pece A, Sannace C, Menchini U, Virgili G, Galli L, Isola V, Brancato R. Fluorescein angiography and indocyanine green angiography for identifying occult choroidal neovascularization in age-related macular degeneration. Eur J Ophthalmol. 2005 Nov-Dec;15(6):759-63. PMID: 16329062. [Crossref]  [PubMed]
  31. Grossniklaus HE, Green WR. Choroidal neovascularization. Am J Ophthalmol. 2004 Mar;137(3):496-503. [Crossref]  [PubMed]
  32. Spaide RF, Jaffe GJ, Sarraf D, Freund KB, Sadda SR, Staurenghi G, et al. Consensus Nomenclature for Reporting Neovascular Age-Related Macular Degeneration Data: Consensus on Neovascular Age-Related Macular Degeneration Nomenclature Study Group. Ophthalmology. 2020 May;127(5):616-636.Epub 2019 Nov 14. Erratum in: Ophthalmology. 2020 Oct;127(10):1434-1435. [Crossref]  [PubMed]  [PMC]
  33. Vaclavik V, Vujosevic S, Dandekar SS, Bunce C, Peto T, Bird AC. Autofluorescence imaging in age-related macular degeneration complicated by choroidal neovascularization: a prospective study. Ophthalmology. 2008 Feb;115(2):342-6. Epub 2007 Jun 28. [Crossref]  [PubMed]
  34. Framme C, Bunse A, Sofroni R, Thalhammer T, Walter A, Sachs HG, Gabel VP. Fundus autofluorescence before and after photodynamic therapy for choroidal neovascularization secondary to age-related macular degeneration. Ophthalmic Surg Lasers Imaging. 2006 Sep-Oct;37(5):406-14. [Crossref]  [PubMed]
  35. Heimes B, Lommatzsch A, Zeimer M, Gutfleisch M, Spital G, Bird AC, et al. Foveal RPE autofluorescence as a prognostic factor for anti-VEGF therapy in exudative AMD. Graefes Arch Clin Exp Ophthalmol. 2008 Sep;246(9):1229-34. Epub 2008 May 29. [Crossref]  [PubMed]
  36. Attarde A, Riad TS, Zhang Z, Ahir M, Fu Y. Characterization of Vascular Morphology of Neovascular Age-Related Macular Degeneration by Indocyanine Green Angiography. J Vis Exp. 2023 Aug 11;(198):10.3791/65682. [Crossref]  [PubMed]  [PMC]
  37. Tsai ASH, Cheung N, Gan ATL, Jaffe GJ, Sivaprasad S, Wong TY, Cheung CMG. Retinal angiomatous proliferation. Surv Ophthalmol. 2017 Jul-Aug;62(4):462-492. Epub 2017 Feb 9. [Crossref]  [PubMed]
  38. Marticorena J, Di Leva V, Cennamo GL, de Crecchio G. Retinal angiomatous proliferation. Curr Drug Targets. 2011 Feb;12(2):199-205. [Crossref]  [PubMed]
  39. Saito M, Itagaki K, Sekiryu T. Fundus autofluorescence of retinal angiomatous proliferation. PLoS One. 2020 Dec 9;15(12):e0243458. [Crossref]  [PubMed]  [PMC]
  40. Koh AH; Expert PCV Panel; Chen LJ, Chen SJ, Chen Y, et al. Polypoidal choroidal vasculopathy: evidence-based guidelines for clinical diagnosis and treatment. Retina. 2013 Apr;33(4):686-716. [Crossref]  [PubMed]
  41. van Dijk EHC, Holtz JK, Sirks MJ, Larsson JME, Diederen RMH, Schlingemann RO, et al. European Prevalence of Polypoidal Choroidal Vasculopathy: A Systematic Review, Meta-Analysis, and Forecasting Study. J Clin Med. 2022 Aug 16;11(16):4766. [Crossref]  [PubMed]  [PMC]
  42. Karadimas P, Bouzas EA. Fundus autofluorescence imaging in serous and drusenoid pigment epithelial detachments associated with age-related macular degeneration. Am J Ophthalmol. 2005 Dec;140(6):1163-5. [Crossref]  [PubMed]
  43. Lommatzsch A. Pigment epithelial detachment in exudative macular degeneration: clinical characteristics and therapeutic options. Ophthalmologe. 2010 Dec;107(12):1115-22. German. [Crossref]  [PubMed]
  44. Heimes B, Farecki ML Jr, Bartels S, Barrelmann A, Gutfleisch M, Spital G, et al. Retinal Pigment Epithelial Tear And Anti-Vascular Endothelial Growth Factor Therapy in Exudative Age-Related Macular Degeneration: Clinical Course and Long-Term Prognosis. Retina. 2016 May;36(5):868-74. [Crossref]  [PubMed]
  45. Sarks J, Tang K, Killingsworth M, Arnold J, Sarks S. Development of atrophy of the retinal pigment epithelium around disciform scars. Br J Ophthalmol. 2006 Apr;90(4):442-6. [Crossref]  [PubMed]  [PMC]