Fundus Autofluorescence

Abstract

Fundus autofluorescence (FAF) images can mark the effects of aging and disease at the level of the retinal pigment epithelium. The in vivo detection of FAF relies primarily on the presence of fluorophors in the lipofuscin (LF) granules of RPE cells, including the bis-retinoid pigment A2-E. With aging the post mitotic RPE cells accumulate LF granules in the cytoplasm, accompanied by a reduction in the density of the melanin granules. Excessive accumulation of LF (and its characteristic FAF signal) is a marker for multifactorial and degenerative maculopathies, including age related macular degeneration (AMD), idiopathic central serous chorioretinopathy, and purely inherited monogenetic diseases such as Best’s vitelliform degeneration and Stargardt’s disease. Until recently, accumulation of RPE lipofuscin could be determined only by fluorescence microscopy. Information about the specific LF content of the RPE and the topographical distribution of its intensity could not be determined by methods other than conventional imaging technologies, including fundus photography, fluorescence angiography or optical coherence tomography.