Topography of fundus autofluorescence using a confocal scanning laser ophthalmoscope

Background: We investigated fundus autofluorescence in vivo using a novel scanning laser ophthalmoscope. Materials and methods: A total of 550 patients with various retinal diseases were examined and compared with normal eyes. Autofluorescence was detected after excitation with an argon blue laser (488 nm), and emission was recorded with a short wavelength cut off above 500 nm. Results: Reduced autofluorescence was observed in the foveal and parafoveal region due to retinal xanthophyll,along the retinal vessels, at the optic nerve head and in areas with atrophy of the retinal pigment epithelium (RPE). Autofluorescence intensity was increased either focally or diffusely in certain degenerative (AMD) or genetically determined retinal diseases (e.g., Slargardt's disease, Best's disease). Conclusions: These findings are in accordance with the view that in vivo fundus aurofluorescence originates at the level of the RPE and suggest that it is derived from lipofuscin.