Patterns of Fundus Autofluorescence Lifetimes In Eyes of Individuals With Nonexudative Age-Related Macular Degeneration

PURPOSE: To investigate fundus autofluorescence (FAF) lifetimes in patients with nonexudative AMD. METHODS: A total of 150 eyes of 110 patients (mean age: 73.2 ± 10.7 years) with nonexudative AMD, as well as a healthy group of 57 eyes in 38 subjects (mean age: 66.5 ± 8.7 years), were included. Investigations were conducted at the University Eye Clinic in Jena, Germany, as well as the Moran Eye Center in Salt Lake City, Utah, USA, using the Heidelberg Engineering Spectralis-based fluorescence lifetime imaging ophthalmoscope (FLIO). A 30° retinal field centered at the fovea was investigated. FAF decays were detected in short (498–560 nm) and long (560–720 nm, LSC) spectral channels. The mean fluorescence lifetimes (τ(m)) were calculated. Optical coherence tomography scans and fundus photographs were also recorded. RESULTS: In patients with nonexudative AMD, FLIO shows a ring-shaped pattern of prolonged τ(m) in the LSC. This pattern occurs in all patients with AMD (including very early stages) and in one-third of the healthy controls. FAF lifetimes were longer with more advanced stages. The presence of drusen is associated with prolonged τ(m) when compared with the healthy fundus, but drusen identification is difficult with FLIO only. CONCLUSIONS: FLIO detects a clear pattern of changes within the fundus, which appears to be AMD-associated. These changes are already visible in early AMD stages and not masked by the presence of other coexisting retinal diseases. These findings may be useful for the early diagnosis of AMD and to distinguish AMD from other retinal diseases.