FUNDUS AUTOFLUORESCENCE: A Useful Retinal Scan for Dry AMD, Geographic Atrophy and CSR
Fundus autofluorescence (FAF) is a specialised, non-invasive retinal imaging test that provides information about the health of the retinal pigment epithelium (RPE) and the outer retina. It can be particularly useful when assessing and monitoring dry age-related macular degeneration (AMD), geographic atrophy and central serous chorioretinopathy (CSR).
Mr Kumar uses FAF as part of a multimodal retinal assessment, alongside clinical examination, optical coherence tomography (OCT), OCT angiography (OCTA), retinal photography and other investigations when appropriate.
What is a FAF scan?
During a FAF examination, a specialised retinal camera uses light to detect naturally occurring fluorescent signals within the retina, particularly those associated with lipofuscin in the RPE. Different patterns of autofluorescence can provide information about retinal and RPE health.
The examination is usually quick, painless and does not require an injection or dye. You simply look at a fixation target while images of the retina are captured. Bright flashes of light may be noticeable during the scan.
Normal FAF
A normal fundus autofluorescence (FAF) image shows a characteristic, relatively uniform pattern of autofluorescence across the macula and retina. This reflects healthy retinal pigment epithelium (RPE) function, with no significant areas of abnormal increased or reduced autofluorescence. The optic disc and blood vessels appear dark because they produce little autofluorescence.
FAF in dry AMD and geographic atrophy
One of the important uses of FAF is in dry AMD and geographic atrophy (GA). FAF can demonstrate areas of retinal pigment epithelial dysfunction and atrophy and help document their size, distribution and changes over time.
In geographic atrophy, areas of established RPE loss typically appear darker on FAF imaging. Patterns surrounding areas of atrophy can also provide useful information when assessing the health of the surrounding retina.
FAF can therefore complement OCT and clinical examination when monitoring patients with advanced dry AMD and geographic atrophy.
FAF in central serous chorioretinopathy
FAF can also be useful in central serous chorioretinopathy (CSR). CSR can cause changes to the retinal pigment epithelium, and FAF may demonstrate patterns associated with current or previous RPE disturbance.
OCT is particularly important for identifying and monitoring fluid beneath the retina. FAF provides complementary information and may help assess the longer-term effects of CSR on the RPE.
Other retinal conditions
FAF can also be useful in selected inherited retinal diseases, including Stargardt disease, retinitis pigmentosa, Best disease, pattern dystrophies and choroideremia.
It may also provide complementary information in selected cases of retinal drug toxicity, inflammatory retinal conditions and other macular disorders.
How Mr Kumar uses FAF
Mr Kumar uses FAF selectively as part of a comprehensive retinal and macular assessment. By combining FAF with OCT, OCTA, clinical examination and other retinal imaging when appropriate, he can obtain complementary information about retinal structure and RPE health.
This multimodal approach can assist with the diagnosis, documentation and monitoring of retinal and macular conditions, helping to assess how retinal changes evolve over time.
If you have dry AMD, geographic atrophy, CSR or another retinal condition, FAF may provide valuable additional information about the health of your retina and macula.
Mr Kumar provides specialist retinal assessment for patients from Reading, Windsor, Berkshire and surrounding areas.
