Blue Light and Green Light Fundus Autofluorescence, Complementary to Optical Coherence Tomography, in Age-Related Macular Degeneration Evaluation
<b>Background:</b> Age-related macular degeneration (AMD) is one of the leading causes of permanent vision loss in the elderly, particularly in higher-income countries. Fundus autofluorescence (FAF) imaging is a widely used, non-invasive technique that complements structural imaging in t...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-07-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/15/13/1688 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850118872913412096 |
|---|---|
| author | Antonia-Elena Ranetti Horia Tudor Stanca Mihnea Munteanu Raluca Bievel Radulescu Simona Stanca |
| author_facet | Antonia-Elena Ranetti Horia Tudor Stanca Mihnea Munteanu Raluca Bievel Radulescu Simona Stanca |
| author_sort | Antonia-Elena Ranetti |
| collection | DOAJ |
| description | <b>Background:</b> Age-related macular degeneration (AMD) is one of the leading causes of permanent vision loss in the elderly, particularly in higher-income countries. Fundus autofluorescence (FAF) imaging is a widely used, non-invasive technique that complements structural imaging in the assessment of retinal pigment epithelium (RPE) integrity. While optical coherence tomography (OCT) remains the gold standard for retinal imaging due to its high-resolution cross-sectional visualization, FAF offers unique metabolic insights. Among the FAF modalities, blue light FAF (B-FAF) is more commonly employed, whereas green light FAF (G-FAF) provides subtly different image characteristics, particularly improved visualization and contrast in the central macula. Despite identical acquisition times and nearly indistinguishable workflows, G-FAF is notably underutilized in clinical practice. <b>Objectives:</b> This narrative review critically compares green and blue FAF in terms of their diagnostic utility relative to OCT, with a focus on lesion detectability, macular pigment interference, and clinical decision-making in retinal disorders. <b>Methods:</b> A comprehensive literature search was performed using the PubMed database for studies published prior to February 2025. The search utilized the keywords fundus autofluorescence and age-related macular degeneration. The primary focus was on short-wavelength FAF and its clinical utility in AMD, considering three aspects: diagnosis, follow-up, and prognosis. The OCT findings served as the reference standard for anatomical correlation and diagnostic accuracy. <b>Results:</b> Both FAF modalities correlated well with OCT in detecting RPE abnormalities. G-FAF demonstrated improved visibility of central lesions due to reduced masking by macular pigment and enhanced contrast in the macula. However, clinical preference remained skewed toward B-FAF, driven more by tradition and device default settings than by evidence-based superiority. G-FAF’s diagnostic potential remains underrecognized despite its comparable practicality and subtle imaging advantages specifically for AMD patients. AMD stages were accurately characterized, and relevant images were used to highlight the significance of G-FAF and B-FAF in the examination of AMD patients. <b>Conclusions:</b> While OCT remains the gold standard, FAF provides complementary information that can guide management strategy. Since G-FAF is functionally equivalent in acquisition, it offers slight advantages. Broader awareness and more frequent integration of G-FAF that could optimize multimodal imaging strategies, particularly in the intermediate stage, should be developed. |
| format | Article |
| id | doaj-art-e16c4e0cadef459fabc37eef17eda414 |
| institution | OA Journals |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-e16c4e0cadef459fabc37eef17eda4142025-08-20T02:35:46ZengMDPI AGDiagnostics2075-44182025-07-011513168810.3390/diagnostics15131688Blue Light and Green Light Fundus Autofluorescence, Complementary to Optical Coherence Tomography, in Age-Related Macular Degeneration EvaluationAntonia-Elena Ranetti0Horia Tudor Stanca1Mihnea Munteanu2Raluca Bievel Radulescu3Simona Stanca4Doctoral School, “Carol Davila” University of Medicine and Pharmacy, Strada Dionisie Lupu No. 37, 020021 București, RomaniaDoctoral School, “Carol Davila” University of Medicine and Pharmacy, Strada Dionisie Lupu No. 37, 020021 București, RomaniaDepartment of Ophthalmology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaDoctoral School, “Carol Davila” University of Medicine and Pharmacy, Strada Dionisie Lupu No. 37, 020021 București, RomaniaClinical Department of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, Strada Dionisie Lupu No. 37, 020021 București, Romania<b>Background:</b> Age-related macular degeneration (AMD) is one of the leading causes of permanent vision loss in the elderly, particularly in higher-income countries. Fundus autofluorescence (FAF) imaging is a widely used, non-invasive technique that complements structural imaging in the assessment of retinal pigment epithelium (RPE) integrity. While optical coherence tomography (OCT) remains the gold standard for retinal imaging due to its high-resolution cross-sectional visualization, FAF offers unique metabolic insights. Among the FAF modalities, blue light FAF (B-FAF) is more commonly employed, whereas green light FAF (G-FAF) provides subtly different image characteristics, particularly improved visualization and contrast in the central macula. Despite identical acquisition times and nearly indistinguishable workflows, G-FAF is notably underutilized in clinical practice. <b>Objectives:</b> This narrative review critically compares green and blue FAF in terms of their diagnostic utility relative to OCT, with a focus on lesion detectability, macular pigment interference, and clinical decision-making in retinal disorders. <b>Methods:</b> A comprehensive literature search was performed using the PubMed database for studies published prior to February 2025. The search utilized the keywords fundus autofluorescence and age-related macular degeneration. The primary focus was on short-wavelength FAF and its clinical utility in AMD, considering three aspects: diagnosis, follow-up, and prognosis. The OCT findings served as the reference standard for anatomical correlation and diagnostic accuracy. <b>Results:</b> Both FAF modalities correlated well with OCT in detecting RPE abnormalities. G-FAF demonstrated improved visibility of central lesions due to reduced masking by macular pigment and enhanced contrast in the macula. However, clinical preference remained skewed toward B-FAF, driven more by tradition and device default settings than by evidence-based superiority. G-FAF’s diagnostic potential remains underrecognized despite its comparable practicality and subtle imaging advantages specifically for AMD patients. AMD stages were accurately characterized, and relevant images were used to highlight the significance of G-FAF and B-FAF in the examination of AMD patients. <b>Conclusions:</b> While OCT remains the gold standard, FAF provides complementary information that can guide management strategy. Since G-FAF is functionally equivalent in acquisition, it offers slight advantages. Broader awareness and more frequent integration of G-FAF that could optimize multimodal imaging strategies, particularly in the intermediate stage, should be developed.https://www.mdpi.com/2075-4418/15/13/1688age-related macular degenerationfundus autofluorescenceoptical coherence tomographyretinal pigment epitheliumscanning laser ophthalmoscopemultimodal imaging |
| spellingShingle | Antonia-Elena Ranetti Horia Tudor Stanca Mihnea Munteanu Raluca Bievel Radulescu Simona Stanca Blue Light and Green Light Fundus Autofluorescence, Complementary to Optical Coherence Tomography, in Age-Related Macular Degeneration Evaluation Diagnostics age-related macular degeneration fundus autofluorescence optical coherence tomography retinal pigment epithelium scanning laser ophthalmoscope multimodal imaging |
| title | Blue Light and Green Light Fundus Autofluorescence, Complementary to Optical Coherence Tomography, in Age-Related Macular Degeneration Evaluation |
| title_full | Blue Light and Green Light Fundus Autofluorescence, Complementary to Optical Coherence Tomography, in Age-Related Macular Degeneration Evaluation |
| title_fullStr | Blue Light and Green Light Fundus Autofluorescence, Complementary to Optical Coherence Tomography, in Age-Related Macular Degeneration Evaluation |
| title_full_unstemmed | Blue Light and Green Light Fundus Autofluorescence, Complementary to Optical Coherence Tomography, in Age-Related Macular Degeneration Evaluation |
| title_short | Blue Light and Green Light Fundus Autofluorescence, Complementary to Optical Coherence Tomography, in Age-Related Macular Degeneration Evaluation |
| title_sort | blue light and green light fundus autofluorescence complementary to optical coherence tomography in age related macular degeneration evaluation |
| topic | age-related macular degeneration fundus autofluorescence optical coherence tomography retinal pigment epithelium scanning laser ophthalmoscope multimodal imaging |
| url | https://www.mdpi.com/2075-4418/15/13/1688 |
| work_keys_str_mv | AT antoniaelenaranetti bluelightandgreenlightfundusautofluorescencecomplementarytoopticalcoherencetomographyinagerelatedmaculardegenerationevaluation AT horiatudorstanca bluelightandgreenlightfundusautofluorescencecomplementarytoopticalcoherencetomographyinagerelatedmaculardegenerationevaluation AT mihneamunteanu bluelightandgreenlightfundusautofluorescencecomplementarytoopticalcoherencetomographyinagerelatedmaculardegenerationevaluation AT ralucabievelradulescu bluelightandgreenlightfundusautofluorescencecomplementarytoopticalcoherencetomographyinagerelatedmaculardegenerationevaluation AT simonastanca bluelightandgreenlightfundusautofluorescencecomplementarytoopticalcoherencetomographyinagerelatedmaculardegenerationevaluation |