Quantitative and Rapid In Vivo Imaging of Human Lenticular Fluorescence.

Purpose: To quantitatively investigate the chemical origins of near-UV excited fluorescence in the crystalline lens, and demonstrate the potential usefulness of a rapid and noninvasive diagnostic approach for screening and monitoring of lens damage.

Methods: Anterior segment UV fluorescence imaging was applied to a population of 30 healthy adults, ages 18 to 64 years. Absolute fluorescence intensities and intensity ratios were compared across the population as a function of age. Fluorescence quantum yield (FQY) was calculated from imaging results based on a previous radiometric characterization.

Results: Typical FQYs at 365 nm excitation are approximately 0.2% for healthy adults. Intensity and FQY were observed to increase significantly with age, consistent with ex vivo and confocal microscopy studies. The ratio of blue to green fluorescence is strongly correlated with FQY and age, suggesting that both increases in fluorophore concentration and changes in composition occur with age. Fluorescence data is quantitatively and qualitatively consistent with pyridine nucleotides in young adults, and changes with age are consistent with formation of β-carbolines or advanced glycation end products. Intralens variation is consistent with increased oxidation or glycation in the lens nucleus relative to the cortex.

Conclusions: Lenticular fluorescence can be measured rapidly, accurately, and quantitatively in vivo which provides a spatially resolved, quantitative measure of lens chemistry, including damage from oxidation and glycation. Careful interpretation of fluorescence intensities and intensity ratios can provide chemical insight into lens health. Anterior segment UV fluorescence imaging can thus serve as a useful tool for screening, monitoring, and research of lens damage and cataract formation.