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Near-Infrared Autofluorescence Imaging of the Fundus: Visualization of Ocular Melanin

¹From the Department of Ophthalmology, University Hospital, Würzburg, Germany; the ²Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts.

PURPOSE. To evaluate the origin of the near-infrared autofluorescence (AF) of the fundus detected by scanning laser ophthalmoscopy and compare the distribution of this AF with that of lipofuscin.

METHODS. AF [787] fundus images (excitation [Exc.] 787 nm; emission [Emi.] >800 nm) were recorded with a confocal scanning laser ophthalmoscope, in 85 normal subjects (ages: 11–77 years) and in 25 patients with AMD and other retinal diseases. Standard AF [488] images (Exc. 488 nm; Emi. >500 nm) were recorded in a subset of the population.

RESULTS. The fovea exhibits higher AF[787] than the perifovea in an area 8° in diameter, roughly equivalent to the area of higher RPE melanin seen in AF[488] and color images. The ratio of foveal to perifoveal AF[787] decreases with age (P < 0.0001) and is higher in subjects with light irides (P = 0.04). Higher AF[787] emanates from hyperpigmentation, from the choroidal pigment (nevi, outer layers) and from the pigment epithelium and stroma of the iris. Low AF[787] is observed in geographic atrophy particularly in subjects with light irides.

CONCLUSIONS. AF[787] originates from the RPE and to a varying degree from the choroid. Oxidized melanin, or compounds closely associated with melanin, contributes substantially to this AF, but other fluorophores cannot be excluded at this stage. Confocal AF[787] imaging may provide a new modality to visualize pathologic features of the RPE and the choroid, and, together with AF[488] imaging, offers a new tool to study biological changes associated with aging of the RPE and pathology.

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