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Monitoring macular pigment changes in macular holes using fluorescence lifetime imaging ophthalmoscopy
Author(s) -
Sauer Lydia,
Peters Sven,
Schmidt Johanna,
Schweitzer Dietrich,
Klemm Matthias,
Ramm Lisa,
Augsten Regine,
Hammer Martin
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13269
Subject(s) - ophthalmoscopy , optical coherence tomography , retinal , macular hole , ophthalmology , medicine , fluorescence , fundus (uterus) , materials science , optics , chemistry , visual acuity , physics , vitrectomy
Purpose To investigate the impact of macular pigment ( MP ) on fundus autofluorescence ( FAF ) lifetimes in vivo by characterizing full‐thickness idiopathic macular holes ( MH ) and macular pseudo‐holes ( MPH ). Methods A total of 37 patients with MH and 52 with MPH were included. Using the fluorescence lifetime imaging ophthalmoscope ( FLIO ), based on a Heidelberg Engineering Spectralis system, a 30° retinal field was investigated. FAF decays were detected in a short (498–560 nm; ch1) and long (560–720 nm; ch2) wavelength channel. τ m , the mean fluorescence lifetime, was calculated from a three‐exponential approximation of the FAF decays. Macular coherence tomography scans were recorded, and macular pigment's optical density ( MPOD ) was measured (one‐wavelength reflectometry). Two MH subgroups were analysed according to the presence or absence of an operculum above the MH . A total of 17 healthy fellow eyes were included. A longitudinal FAF decay examination was conducted in nine patients, which were followed up after surgery and showed a closed MH . Results In MH without opercula, significant τ m differences (p < 0.001) were found between the hole area ( MH a) and surrounding areas ( MH b) (ch1: MH a 238 ± 64 ps, MH b 181 ± 78 ps; ch2: MH a 275 ± 49 ps, MH b 223 ± 48 ps), as well as between MH a and healthy eyes or closed MH . Shorter τ m , adjacent to the hole, can be assigned to areas with equivalently higher MPOD . Opercula containing MP also show short τ m . In MPH , the intactness of the Hele fibre layer is associated with shortest τ m . Conclusions Shortest τ m originates from MP ‐containing retinal layers, especially from the Henle fibre layer. Fluorescence lifetime imaging ophthalmoscope (FLIO) provides information on the MP distribution, the pathogenesis and topology of MH . Macular pigment (MP) fluorescence may provide a biomarker for monitoring pathological changes in retinal diseases.