Comparison of Short-Wavelength Reduced-Illuminance and Conventional Autofluorescence Imaging in Stargardt Macular Dystrophy.

TitleComparison of Short-Wavelength Reduced-Illuminance and Conventional Autofluorescence Imaging in Stargardt Macular Dystrophy.
Publication TypeJournal Article
Year of Publication2016
AuthorsStrauss, RW, Muñoz, B, Jha, A, Ho, A, Cideciyan, AV, Kasilian, ML, Wolfson, Y, Sadda, SV, West, S, Scholl, HPN, Michaelides, M
JournalAm J Ophthalmol
Volume168
Pagination269-78
Date Published2016 Aug
ISSN1879-1891
KeywordsAdult, Female, Fluorescein Angiography, Fundus Oculi, Humans, Macula Lutea, Macular Degeneration, Male, Middle Aged, Ophthalmoscopy, Optical Imaging, Reproducibility of Results
Abstract

PURPOSE: To compare grading results between short-wavelength reduced-illuminance and conventional autofluorescence imaging in Stargardt macular dystrophy.

DESIGN: Reliability study.

METHODS: setting: Moorfields Eye Hospital, London (United Kingdom).

PATIENTS: Eighteen patients (18 eyes) with Stargardt macular dystrophy.

OBSERVATION PROCEDURES: A series of 3 fundus autofluorescence images using 3 different acquisition parameters on a custom-patched device were obtained: (1) 25% laser power and total sensitivity 87; (2) 25% laser power and freely adjusted sensitivity; and (3) 100% laser power and freely adjusted total sensitivity (conventional). The total area of 2 hypoautofluorescent lesion types (definitely decreased autofluorescence and poorly demarcated questionably decreased autofluorescence) was measured.

MAIN OUTCOME MEASURES: Agreement in grading between the 3 imaging methods was assessed by kappa coefficients (κ) and intraclass correlation coefficients.

RESULTS: The mean ± standard deviation area for images acquired with 25% laser power and freely adjusted total sensitivity was 2.04 ± 1.87 mm(2) for definitely decreased autofluorescence (n = 15) and 1.86 ± 2.14 mm(2) for poorly demarcated questionably decreased autofluorescence (n = 12). The intraclass correlation coefficient (95% confidence interval) was 0.964 (0.929, 0.999) for definitely decreased autofluorescence and 0.268 (0.000, 0.730) for poorly demarcated questionably decreased autofluorescence.

CONCLUSIONS: Short-wavelength reduced-illuminance and conventional fundus autofluorescence imaging showed good concordance in assessing areas of definitely decreased autofluorescence. However, there was significantly higher variability between imaging modalities for assessing areas of poorly demarcated questionably decreased autofluorescence.

DOI10.1016/j.ajo.2016.06.003
Alternate JournalAm. J. Ophthalmol.
PubMed ID27296491
PubMed Central IDPMC4977015
Grant ListU54 HG006542 / HG / NHGRI NIH HHS / United States