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. 2013;6(1):75-80.
doi: 10.3980/j.issn.2222-3959.2013.01.16. Epub 2013 Feb 18.

Green-light fundus autofluorescence in diabetic macular edema

Lukas Reznicek  1 , Simeon Dabov, Christos Haritoglou, Anselm Kampik, Marcus Kernt, Aljoscha S Neubauer
Affiliations

Green-light fundus autofluorescence in diabetic macular edema

Lukas Reznicek et al. Int J Ophthalmol. 2013.

Abstract

Aim: To evaluate the role of central green-light fundus autofluorescence (FAF) in diabetic macular edema (DME).

Methods: A consecutive series of 92 study eyes with diabetic retinopathy were included. Out of those, 51 diabetic eyes had DME and were compared to 41 diabetic eyes without DME. In all subjects, green-light FAF images were obtained, quantified and classified into various FAF patterns. Cross-sectional optical coherence tomography (OCT) scans were obtained for evaluation of Inner/Outer segment (IS/OS) layer integrity, measurements of central RPE-IS/OS layer thickness as well as classification of DME into various subtypes.

Results: Mean central green-light FAF intensity of eyes with DME (1.289±0.140)log did not significantly differ from diabetic patients without DME (1.317±0.137)log. Most classifiable FAF patterns were seen in patients with cystoid DME. Mean central retinal thickness (CRT) of all study eyes with DME was (501.9±112.4)µm compared to (328.2±27.0)µm in diabetic patients without DME. Patients with DME had significantly more disrupted photoreceptor IS/OS layers than diabetic patients without DME (28/51 vs 5/41, P<0.001). Mean RPE-IS/OS thickness of patients with DME (60.7±14.1)µm was significantly (P<0.001) lower than in diabetic eyes without DME (73.5±9.4)µm. Correlation analys1s revealed non-significant correlations of green-light FAF intensity and OCT parameters in all subtypes of DME.

Conclusion: Our results indicate a poor correlation of central green-light FAF intensity with CRT, IS/OS layer integrity or RPE-IS/OS layer thickness in diabetic patients with or without DME and its various subtypes. Thus, central green-light FAF is not suitable for detection of retinal thickening in DME.

Keywords: diabetic macular edema; fundus autofluorescence; optical coherence tomography.

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Figures

Figure 1
Figure 1. A: OCT volume scan of one left study eye with overlaid retinal thickness map, red/orange indicate higher values vs green/blue which indicate lower values; B: Green-light FAF image of left study eye, various grayscale intensities indicate various FAF signal intensities (0=black to 255=white). C and D: Quantification of FAF intensity using Matlab based software with marking of the fovea (C) and obtained FAF intensity scale ranging from 0 (black) to 255 (white) shown as function of pixel distance from the marked fovea center in logarithmic scale.
Figure 2
Figure 2. Interrupted (A) and partially interrupted (B) IS/OS layer band in patient with cystoid DME compared to continuous (C) IS/OS layer band in patient without DME in cross-sectional OCT scans.
Figure 3
Figure 3. OCT volume scan pattern based classification of DME into diffuse (A) and focal (B) DME compared to non DME group (C).
Figure 4
Figure 4. OCT cross-sectional scan based classification of DME into cystoid (A) and non-cystoid (B) DME compared to non DME group (C).
Figure 5
Figure 5. Normal (A), single-spot (B) and multi-spot (C) increased FAF pattern of included patients with DME.
Figure 6
Figure 6. Cross-sectional OCT scan (A) through macula of study eye without DME and detail (B) of its foveal region with RPE-IS/OS measurement (asterisk).
Figure 7
Figure 7. Significant correlation with regression curve between central retinal thickness (CRT) and RPE layer thickness in µm in all 92 study eyes.
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