New technology using crystalline lens autofluorescence for presbyopia and cataract grading

PurposeTo 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.MethodsSixty 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.ResultsThe 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 (R-2 = 0.637; beta coefficient = 1.009; 95% CI, 0.748 to 1.271; p < 0.001) and nuclear cataract grade (R-2 = 0.661; beta coefficient = 12.437; 95% CI, 10.097 to 14.778; p < 0.001).ConclusionsThe FAF camera with an artificial opacity pattern attached can be used to effectively diagnose the degree of presbyopia and nuclear cataract.