title: Monitoring macular pigment changes in macular holes using fluorescence lifetime imaging ophthalmoscopy.
abstract: OBJECTIVE
  To investigate the impact of macular pigment (MP) on fundus autofluorescence (FAF) lifetimes in vivo by characterizing full-thickness idiopathic macular holes (MH) and macular pseudo-holes (MPH).
  
  
  METHODS
  A total of 37 patients with MH and 52 with MPH were included. Using the fluorescence lifetime imaging ophthalmoscope (FLIO), based on a Heidelberg Engineering Spectralis system, a 30° retinal field was investigated. FAF decays were detected in a short (498-560 nm; ch1) and long (560-720 nm; ch2) wavelength channel. τm, the mean fluorescence lifetime, was calculated from a three-exponential approximation of the FAF decays. Macular coherence tomography scans were recorded, and macular pigment's optical density (MPOD) was measured (one-wavelength reflectometry). Two MH subgroups were analysed according to the presence or absence of an operculum above the MH. A total of 17 healthy fellow eyes were included. A longitudinal FAF decay examination was conducted in nine patients, which were followed up after surgery and showed a closed MH.
  
  
  RESULTS
  In MH without opercula, significant τmdifferences (p < 0.001) were found between the hole area (MHa) and surrounding areas (MHb) (ch1: MHa 238 ± 64 ps, MHb 181 ± 78 ps; ch2: MHa 275 ± 49 ps, MHb 223 ± 48 ps), as well as between MHa and healthy eyes or closed MH. Shorter τm, adjacent to the hole, can be assigned to areas with equivalently higher MPOD. Opercula containing MP also show short τm. In MPH, the intactness of the Hele fibre layer is associated with shortest τm.
  
  
  CONCLUSIONS
  Shortest τmoriginates from MP-containing retinal layers, especially from the Henle fibre layer. Fluorescence lifetime imaging ophthalmoscope (FLIO) provides information on the MP distribution, the pathogenesis and topology of MH. Macular pigment (MP) fluorescence may provide a biomarker for monitoring pathological changes in retinal diseases.
authors: Department of Ophthalmology, University Hospital Jena, Jena, Germany.
authors: Lydia
authors: L
authors: Sauer
authors: Department of Ophthalmology, University Hospital Jena, Jena, Germany.
authors: Sven
authors: S
authors: Peters
authors: Department of Ophthalmology, University Hospital Jena, Jena, Germany.
authors: Johanna
authors: J
authors: Schmidt
authors: Department of Ophthalmology, University Hospital Jena, Jena, Germany.
authors: Dietrich
authors: D
authors: Schweitzer
authors: Institute of Biomedical Engineering and Informatics, Technical University Ilmenau, Ilmenau, Germany.
authors: Matthias
authors: M
authors: Klemm
authors: Department of Ophthalmology, University Hospital Carl-Gustav Carus, TU Dresden, Germany.
authors: Lisa
authors: L
authors: Ramm
authors: Department of Ophthalmology, University Hospital Jena, Jena, Germany.
authors: Regine
authors: R
authors: Augsten
authors: Department of Ophthalmology, University Hospital Jena, Jena, Germany.|Center for Medical Optics and Photonics, University of Jena, Jena, Germany.
authors: Martin
authors: M
authors: Hammer
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D009887:Ophthalmoscopy / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012167:Retinal Perforations / Q000175:diagnosis*; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods; D014792:Visual Acuity
keywords: 
  FLIO
  ; fluorescence lifetime imaging; macular holes; macular pigment