Presbyopia And Cataract Grading Using Crystalline Lens Autofluorescence

Fundus autofluorescence (FAF) reflects the distribution of lipofuscin, a dominant fluorophore located in the retinal pigment epithelium. The purpose of this study was to see if FAF from an ultra-wide-field (UWF) fundus camera with an artificial opacity pattern may be used to evaluate the degree of presbyopia and nuclear cataract.

Korea University Ansan Hospital.

This prospective diagnostic investigation included sixty eyes from 30 individuals. The Lens Opacity Classification System III was used to classify the nuclear cataract (nuclear color/opalescence [NC/NO]). In eyes with NC3/NO3 or less, the monocular near point of accommodation (NPA) was measured. In the retinal AF, the mean grey value difference between the central 8 artificial opacity lesions and the periphery 8 artificial opacity lesions were measured. The correlation between the mean grey value difference, NPA, and nuclear cataract grade was analyzed.

The average nuclear cataract grade in 60 eyes was 3.2 ± 1.6, and the average NPA in 37 eyes was 45.3 ± 16.1 cm. The mean gray value disparities rose as nuclear cataract grade increased (eyes with NC/NO grade 1, 53.3 ± 11.4; grade 2, 78.3 ± 13.6; grade 3, 95.2 ± 12.2; grade 4, 101.6 ± 11.9; grade 5, 109.0 ± 22.9; and grade 6, 121.1 ± 12.0; p < 0.001). The difference in mean grey value was positively correlated with both monocular NPA (R² = 0.637; β coefficient = 1.009; 95% confidence interval (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).

The FAF acquired using an ultra-wide-field (UWF)-fundus camera equipped with an artificial opacity patterns filter increased with rising nuclear cataract grade and deteriorating presbyopia. The FAF camera, which has an artificial opacity pattern attached, may be used to objectively evaluate the degree of presbyopia and nuclear cataract.