New technology using crystalline lens autofluorescence for presbyopia and cataract grading

Graefes Arch Clin Exp Ophthalmol. 2023 Jul;261(7):1923-1932. doi: 10.1007/s00417-023-05999-1. Epub 2023 Feb 24.

Abstract

Purpose: To investigate whether fundus autofluorescence (FAF) obtained using an ultra-wide field (UWF) fundus camera with an artificial opacity pattern can grade the degree of presbyopia and nuclear cataract.

Methods: Sixty eyes of 30 patients were enrolled in this prospective diagnostic study. The nuclear cataract (nuclear color/opalescence (NC/NO)) was graded according to the Lens Opacity Classification System III. The monocular near point of accommodation (NPA) was measured in eyes with NC3/NO3 or less. The mean gray value difference between the central 8 artificial opacity lesions and peripheral 8 artificial opacity lesions in the retinal AF was measured. The correlation between the mean gray value difference, NPA, and nuclear cataract grade was analyzed.

Results: The mean nuclear cataract grade of 60 eyes was 3.2 ± 1.6 and mean NPA of 37 eyes was 45.3 ± 16.1 cm. The mean gray value differences increased with increasing nuclear cataract grade (eyes with NC/NO grade 1, 53.3 ± 11.4; 2, 78.3 ± 13.6; 3, 95.2 ± 12.2; 4, 101.6 ± 11.9; 5, 109.0 ± 22.9; and 6, 121.1 ± 12.0; p < 0.001). The mean gray value difference was positively correlated with both the monocular NPA (R2 = 0.637; β coefficient = 1.009; 95% CI, 0.748 to 1.271; p < 0.001) and nuclear cataract grade (R2 = 0.661; β coefficient = 12.437; 95% CI, 10.097 to 14.778; p < 0.001).

Conclusions: The FAF camera with an artificial opacity pattern attached can be used to effectively diagnose the degree of presbyopia and nuclear cataract.

Keywords: Autofluorescence; Cataract; Crystalline lens; Diagnosis; Presbyopia.

MeSH terms

  • Cataract* / diagnosis
  • Cataract* / pathology
  • Humans
  • Lens, Crystalline* / diagnostic imaging
  • Lens, Crystalline* / pathology
  • Presbyopia* / diagnosis
  • Prospective Studies
  • Technology

Supplementary concepts

  • Cataract, zonular