Zusammenfassung
Die Nahinfrarot-Autofluoreszenz (NIA) ist ein nicht-invasives Verfahren zur Untersuchung
des retinalen Pigmentepithels (RPE) basierend auf der Darstellung des antioxidativen
Schutzfaktors
Melanin in den RPE-Zellen. Die NIA verbessert die Früherkennung chorioretinaler
Erkrankungen, da bei vielen dieser Erkrankungen mit der NIA Strukturveränderungen
des RPE nachweisbar sind,
bevor sich in anderen Untersuchungen Krankheitszeichen erkennen lassen.
Abstract
Near-infrared autofluorescence (NIA) is a non-invasive retinal imaging technique for
examination of the retinal pigment epithelium (RPE) based on the autofluorescence
of melanin. Melanin
has several functions within the RPE cells, in one of them it serves as a protective
antioxidative factor within the RPE cells and is involved in the phagocytosis of photoreceptor
outer
segments. Disorders that affect the photoreceptor-RPE complex result in alterations
of RPE cells which are detectable by alterations of NIA. Therefore, NIA allows to
detect early alterations
in inherited and acquired chorioretinal disorders, frequently prior to ophthalmoscopical
visualisation and often prior to alterations in lipofuscin associated fundus autofluorescence
(FAF)
or optical coherence tomography (OCT). Although NIA and FAF relate to disorders
affecting the RPE, findings between both imaging methods differ and the area involved
has been demonstrated to
be larger in NIA compared to FAF in several disorders (e.g., age-related macular
degeneration, retinitis pigmentosa, ABCA4-gene associated Stargardt disease and cone-rod
dystrophy, light
damage), indicating that NIA detects earlier alterations compared to FAF. In
addition, due to the absence of blue-light filtering which limits foveal visualisation
in FAF, foveal alterations
can be much better detected using NIA. A reduced subfoveal NIA intensity is the
earliest sign of autosomal dominant BEST1-associated disease, when FAF and OCT are
still normal. In other
disorders, a normal subfoveal NIA intensity is associated with good visual acuity.
This review summarizes the present knowledge on NIA and demonstrates biomarkers for
various chorioretinal
disorders.
Schlüsselwörter
nichtinvasive retinale Bildgebung - Nahinfrarot-Autofluoreszenz - retinales Pigmentepithel
- Photorezeptoren - retinale Erkrankungen
Key words
non-invasive retinal imaging - near-infrared fundus autofluorescence - retinal pigment
epithelium - photoreceptors - retinal disorders
