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Am J Ophthalmol. 2016 Aug;168:269-278. doi: 10.1016/j.ajo.2016.06.003. Epub 2016 Jun 11.

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

Author information

1
Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland; Moorfields Eye Hospital, London, United Kingdom; University College London, Institute of Ophthalmology, London, United Kingdom.
2
Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
3
Doheny Image Reading Center, Los Angeles, California.
4
Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
5
Moorfields Eye Hospital, London, United Kingdom.
6
Doheny Image Reading Center, Los Angeles, California; David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.
7
Moorfields Eye Hospital, London, United Kingdom; University College London, Institute of Ophthalmology, London, United Kingdom. Electronic address: michel.michaelides@ucl.ac.uk.

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.

PMID:
27296491
PMCID:
PMC4977015
DOI:
10.1016/j.ajo.2016.06.003
[Indexed for MEDLINE]
Free PMC Article
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