Clinical application of ultra-widefield fundus autofluorescence
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REVIEW
Clinical application of ultra-widefield fundus autofluorescence Amin Xu . Changzheng Chen
Received: 20 March 2020 / Accepted: 1 October 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To review the basic principles of ultrawidefield fundus autofluorescence (UWF-FAF) and discuss its clinical application for a variety of retinal and choroidal disorders. Methods A systematic review of the PubMed database was performed using the search terms ‘‘ultra-widefield,’’ ‘‘autofluorescence,’’ ‘‘retinal disease’’ and ‘‘choroidal disease.’’ Results UWF-FAF imaging is a recently developed noninvasive retinal imaging modality with a wide imaging range that can locate peripheral fundus lesions that traditional fundus autofluorescence cannot. Multiple commercially available ultra-widefield imaging systems, including Heidelberg Spectralis and Optomap Ultra-Widefield systems, are available to the clinician. Imaging by UWF-FAF is more comprehensive; it can reflect the content and distribution of the predominant ocular fluorophore in retinal pigment epithelial cells and evaluate the metabolic status of RPE of various retinal and choroidal disorders. Conclusion UWF-FAF can detect abnormalities that traditional fundus autofluorescence cannot; therefore, it can be used to better elucidate disease pathogenesis,
A. Xu C. Chen (&) Department of Ophthalmology of Renmin Hospital of Wuhan University, No238, Jiefang Road, Wuhan 430060, Hubei, China e-mail: [email protected]
analyze genotype–phenotype correlations, diagnose and monitor disease. Keywords Ultra-widefield Autofluorescence Retinal disease Choroidal disease
Background Fundus autofluorescence (FAF) imaging is a noninvasive technology that can be used to detect the predominant ocular fundus fluorophores and naturally occurring molecules that absorb and emit light of specified wavelengths [1]. Since it was first reported by Delori in the 1980s, the application of FAF has enlarged in both practice and scope [1]. FAF imaging is particularly useful for assessing the types of diseases with modified RPE cells, including those with degenerative, dystrophic, inflammatory, infectious, neoplastic, and toxic etiologies. In addition, compared to the traditional fundus camera that is capable of acquiring 30° to 55° views of the posterior pole, ultra-widefield FAF (UWF-FAF) imaging allows visualization of peripheral ocular fundus lesions that FAF imaging is unable to detect (Fig. 1). Therefore, ultra-widefield (UWF) imaging is considered a supplementary optimal diagnostic method when evaluating the retina in its entirety. This review summarizes commonly used ocular fluorophores, various UWF-FAF imaging modalities, and the advantages and broad clinical
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Int Ophthalmol
Fig. 1 Comparison of common imaging systems available for fundus autofluorescence. Images of healthy retina were obtained using the fundus camera with 30° (a), 55° (b), or 200° (c)
applications of UWF-FAF imaging and then highlights emerging research trends.
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