Use digital subtraction images of blue-light and near-infrared autofluorescence for the assessment of irregular foveal contour

The aims of this study are to generate subtraction images of blue-light autofluorescence (BL-AF) and near-infrared autofluorescence (NIR-AF) from normal eyes, eyes with full thickness macular holes, and eyes with irregular foveal contour, and to compare their autofluorescence patterns. This retrospective study included 44 normal eyes of 22 health individuals, 32 eyes with full thickness macular holes of 32 patients, and 36 eyes with irregular foveal contour of 36 patients. BL-AF and NIR-AF were obtained from all patients and used to generate subtraction images using the Image J software. The decreased signal of central patch was recorded. The central foveal thickness (CFT) and outer nucleus layer (ONL) thickness of fovea were measured to calculate the ONL thickness/CFT ratio. The subtraction images showed regularly increased signal in the central macula of all normal eyes. In contrast, decreased signal of central patch was detected in all full thickness macular holes eyes and 26 out of 36 eyes with irregular foveal contour. No significant difference of the ONL thickness/CFT ratio (F = 2.32, P = 0.113) was observed between normal and irregular foveal contour eyes with or without decreased signal of central patch. Both regularly increased signal and decreased signal of central patch were detected in the eyes with irregular foveal contour. Our results suggest that subtraction images are useful for the assessment of certain macular conditions by providing supplementary information to the green-light autofluorescence and BL-AF.