Comparison of Short-Wavelength Reduced-Illuminance and Conventional Autofluorescence Imaging in Stargardt Macular Dystrophy.
To compare grading results between short-wavelength reduced-illuminance and conventional autofluorescence imaging in Stargardt macular dystrophy.



Reliability study.



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



Eighteen patients (18 eyes) with Stargardt macular dystrophy.



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.



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



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.



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.
Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland; Moorfields Eye Hospital, London, United Kingdom; University College London, Institute of Ophthalmology, London, United Kingdom.
Rupert W
RW
Strauss
Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
Beatriz
B
Muñoz
Doheny Image Reading Center, Los Angeles, California.
Anamika
A
Jha
Doheny Image Reading Center, Los Angeles, California.
Alexander
A
Ho
Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Artur V
AV
Cideciyan
Moorfields Eye Hospital, London, United Kingdom.
Melissa L
ML
Kasilian
Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
Yulia
Y
Wolfson
Doheny Image Reading Center, Los Angeles, California; David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.
SriniVas
S
Sadda
Doheny Image Reading Center, Los Angeles, California; David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.
Sheila
S
West
Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
Hendrik P N
HPN
Scholl
Moorfields Eye Hospital, London, United Kingdom; University College London, Institute of Ophthalmology, London, United Kingdom. Electronic address: michel.michaelides@ucl.ac.uk.
Michel
M
Michaelides
D000328:Adult; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008268:Macular Degeneration / Q000151:congenital* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy / Q000379:methods; D061848:Optical Imaging / Q000379:methods*; D015203:Reproducibility of Results; D000080362:Stargardt Disease