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Richard F. Spaide, MD

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I read with interest the article by Field et al.¹ The authors ascribe autofluorescence measured using a fundus camera system to flavoprotein autofluorescence (FA), but seemingly do not account for other possible sources of the fluorescence measured or for the effect macular pigments may have on recording autofluorescence originating from the outer retina and retinal pigment epithelium (RPE).

Autofluorescence imaging with a fundus camera has the inherent difficulty of recording autofluorescence from every structure in the light path, not just from a region of interest. In addition, many fluorophores within the eye have overlapping excitation and emission spectra. For example, both the cornea and lens display autofluorescence, and the amount of autofluorescence is increased in diabetic persons compared with nondiabetic persons; for the lens, the increase is proportional to the hemoglobin A_1C levels.^2-3 Cataract formation is associated with increasing autofluorescence, and cataracts are more prevalent in . . . [Full Text of this Article]

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