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      Imaging Lenticular Autofluorescence in Older Subjects


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          To evaluate whether a practical method of imaging lenticular autofluorescence (AF) can provide an individualized measure correlated with age-related lens yellowing in older subjects undergoing tests involving shorter wavelength lights.


          Lenticular AF was imaged with 488-nm excitation using a confocal scanning laser ophthalmoscope (cSLO) routinely used for retinal AF imaging. There were 75 older subjects (ages 47–87) at two sites; a small cohort of younger subjects served as controls. At one site, the cSLO was equipped with an internal reference to allow quantitative AF measurements; at the other site, reduced-illuminance AF imaging (RAFI) was used. In a subset of subjects, lens density index was independently estimated from dark-adapted spectral sensitivities performed psychophysically.


          Lenticular AF intensity was significantly higher in the older eyes than the younger cohort when measured with the internal reference (59.2 ± 15.4 vs. 134.4 ± 31.7 gray levels; P < 0.05) as well as when recorded with RAFI without the internal reference (10.9 ± 1.5 vs. 26.1 ± 5.7 gray levels; P < 0.05). Lenticular AF was positively correlated with age; however, there could also be large differences between individuals of similar age. Lenticular AF intensity correlated well with lens density indices estimated from psychophysical measures.


          Lenticular AF measured with a retinal cSLO can provide a practical and individualized measure of lens yellowing, and may be a good candidate to distinguish between preretinal and retinal deficits involving short-wavelength lights in older eyes.

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          Most cited references56

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          In vivo fluorescence of the ocular fundus exhibits retinal pigment epithelium lipofuscin characteristics.

          To characterize the intrinsic fluorescence (autofluorescence) of the human ocular fundus with regard to its excitation and emission spectra, age relationship, retinal location, and topography, and to identify the dominant fluorophore among the fundus layers. Using a novel fundus spectrophotometer, fluorescence measurements were made at 7 degrees temporal to the fovea and at the fovea in 30 normal subjects and in 3 selected patients. Topographic measurements were made in 3 subjects. Ex vivo measurements of fluorescence of human retinal pigment epithelium (RPE) were obtained and compared to in vivo data. Fundus fluorescence reveals a broad band of emission between 500 and 750 nm, a maximum of approximately 630 nm, and optimal excitation of approximately 510 nm. Exhibiting a significant increase with age, this fluorescence is highest at 7 degrees to 15 degrees from the fovea, shows a well-defined foveal minimum, and decreases toward the periphery. In vivo fluorescence spectra are consistent with those obtained ex vivo on human RPE. Measurements with short wavelength excitation are strongly influenced by ocular media absorption and reveal an additional minor fluorophore in the fovea. Spectral characteristics, correlation with age, topographic distribution, and retinal location between the choriocapillaris and the photoreceptors suggest that the dominant fundus fluorophore is RPE lipofuscin. The minor fluorophore is probably in the neurosensory retina but has not been identified.
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            Aging of the human lens.

            The optical density of the human lens changes during life. Literature concerning both the spectral density function and the rate of such changes is reviewed. Analysis indicates that two components govern the spectral lens density function, with one increasing gradually during life. The average lens density increases linearly at 400 nm by 0.12 density unit per decade between the ages of 20 and 60 and by 0.40 density unit per decade above age 60. A tabulation of the two components of the average 32-yr old lens is given, as are equations to derive the average spectral lens density functions for observers aged 20-80.
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              Quantitative measurements of autofluorescence with the scanning laser ophthalmoscope.

              To evaluate the feasibility and reliability of a standardized approach for quantitative measurements of fundus autofluorescence (AF) in images obtained with a confocal scanning laser ophthalmoscope (cSLO).

                Author and article information

                Invest Ophthalmol Vis Sci
                Invest. Ophthalmol. Vis. Sci
                Investigative Ophthalmology & Visual Science
                The Association for Research in Vision and Ophthalmology
                October 2017
                : 58
                : 12
                : 4940-4947
                [1 ]Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
                [2 ]Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
                [3 ]Department of Surgery (Ophthalmology), The University of Melbourne, Parkville, Victoria, Australia
                Author notes
                Correspondence: Artur V. Cideciyan, Scheie Eye Institute, 51 North 39th Street, Philadelphia, PA 19104, USA; cideciya@ 123456pennmedicine.upenn.edu .
                iovs-58-11-40 IOVS-17-22540R2
                Copyright 2017 The Authors

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                : 3 July 2017
                : 29 August 2017

                aging,amd,lens density,night vision,pre-retinal absorption,psychophysics,quantitative autofluorescence,reduced-illuminance autofluorescence imaging,rafi,scotopic testing


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