0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Commentary |

New Understanding of Age-Related Macular Degeneration Through Quantitative Autofluorescence

R. Theodore Smith, MD, PhD1
[+] Author Affiliations
1Department of Ophthalmology, New York University School of Medicine, New York
JAMA Ophthalmol. 2016;134(7):824-826. doi:10.1001/jamaophthalmol.2016.1466.
Text Size: A A A
Published online

Extract

The study of Gliem et al1 in this issue of JAMA Ophthalmology appears to be the first application of the powerful quantitative autofluorescence (qAF) technology to age-related macular degeneration (AMD) and warrants our full attention. To appreciate the significance of this study, recall that the retinal pigment epithelium (RPE) has been clinically imaged for nearly 2 decades by AF scans that record the AF of its lipofuscin granules. The value of clinical AF imaging for phenotype description and as a qualitative disease marker has continued to grow exponentially, not only in retinal degenerations such as AMD, Stargardt disease, and Best disease, but also in the wide spectrum of inflammatory disorders and choroidal tumors. Quantitative AF, introduced in 2011, is performed by calibrating the AF image to an embedded reference of known fluorescence efficiency, making it possible to reproducibly quantify and compare the AF intensity of the RPE, a surrogate for its lipofuscin content, between patients and across time. For example, a broad increase in qAF with age in individuals with healthy eyes was confirmed, documenting how lipofuscin accumulates. Interesting and unexplained sex and ethnic variations in these trends were found. The addition of qAF to the study of genotype/phenotype correlation in Stargardt disease has begun, with milder disease phenotypes generally associated with lower qAF levels. In Best disease, qAF levels are normal outside the Best vitelliform lesion itself, which is an interesting conundrum in a panretinal disease. More applications will follow.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

295 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();