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Green emission fluorophores in eyes with atrophic age-related macular degeneration: a colour fundus autofluorescence pilot study
  1. Enrico Borrelli1,2,3,
  2. Jianqin Lei1,2,4,
  3. Siva Balasubramanian1,2,
  4. Akihito Uji1,2,
  5. Mariano Cozzi5,
  6. Valentina Sarao6,7,
  7. Paolo Lanzetta6,7,
  8. Giovanni Staurenghi5,
  9. SriniVas R Sadda1,2
  1. 1 Doheny Eye Institute, Doheny Image Reading Center, Los Angeles, California, USA
  2. 2 Department of Ophthalmology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California, USA
  3. 3 Department of Medicine and Science of Ageing, Ophthalmology Clinic, University G. D’Annunzio Chieti-Pescara, Chieti, Italy
  4. 4 1st Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
  5. 5 Department of Biomedical and Clinical Science, Eye Clinic Luigi Sacco Hospital, University of Milan, Milan, Italy
  6. 6 Istituto Europeo di Microchirurgia Oculare —IEMO, Udine, Italy
  7. 7 Department of Ophthalmology, University of Udine, Piazzale S. Maria della Misericordia, Udine, Italy
  1. Correspondence to Dr SriniVas R Sadda, Doheny Image Reading Center, 1355 San Pablo Street, Suite 211, Los Angeles, California 90033, USA; ssadda{at}


Background/Aims To investigate the presence of short-wave fluorophores within regions of age-related macular degeneration (AMD)-associated macular atrophy (MA) area.

Methods This is a prospective, observational, cross-sectional case series. 25 eyes (18 patients) with late AMD and clinically identified MA were enrolled. Eyes were imaged using a confocal light-emitting diode blue-light fundus autofluorescence (FAF) device (EIDON, CenterVue, Padua, Italy) with 450 nm excitation wavelength and the capability for ‘colour’ FAF imaging, including both the individual red and green components of the emission spectrum. To produce images with a high contrast for isolating the green component, the red component was subtracted from the total FAF image. The main outcome measure was the presence of green emission fluorescence component (GEFC) within the MA area. Volume spectral domain optical coherence tomography (SD-OCT) scans were obtained through the macula and the OCT was correlated with the MA lesions identified on the FAF images, including regions of increased GEFC.

Results Of the investigated eyes, 11 out of 25 (44.0 %) showed the absence of GEFC in the MA area, whereas 14 eyes (56.0%) were characterised by GEFC within the MA area. The presence and distribution of GEFC in the MA area correlated with the presence of hyper-reflective material over Bruch’s membrane on the corresponding SD-OCT scans.

Conclusion Short-wave fluorophores, which contribute to the GEFC, are present in the MA area and appear to correspond to residual debris or drusenoid material. Short-wavelength fluorophores revealed by colour FAF imaging may warrant further study.

  • imaging
  • retina
  • autofluorescence
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  • Handling editor Jost B Jonas

  • Contributors EB, JL and SRS: conception and design of the study. EB, JL, SB and SRS: patients’ enrolment and data acquisition. EB, JL, SB, AU and SRS: data analysis. All authors: interpretation of data. EB: drafting the article. PL, GS and SRS: revising it critically for important intellectual content. All authors: final approval of the version to be published.

  • Competing interests PL: financial supportBayer, Centervue, Genentech, Novartis, Roche; GS: financial supportNovartis, Alcon, Bayer, Allergan, Boehringer Ingelheim, Genentech, Roche, Zeiss Meditec, Heidelberg Engineering, Optos, Centervue; SRS: financial supportAllergan, Carl Zeiss Meditec, Genentech, Iconic, Novartis, Optos, Optovue, Regeneron, Thrombogenics.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval The study was approved by the UCLA institutional review board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Presented at 17th EURETINA Congress, Barcelona, Spain, EU.

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