Lens Density Research Articles

Correlation between lens thickness and lens density in patients with mild to moderate cataracts

PurposeTo determine the relationships between lens thickness (LT), lens density and anterior segment parameters in patients with mild to moderate cataracts.SettingOftalmosalud Instituto de Ojos, Lima, Perú.DesignProspective, single-centre, cross-sectional study.Methods169 eyes...

Energy load and state of corneal endothelium in hybrid (femtosecond laser-assisted) and torsional phacoemulsification

To compare the intraoperative energy load and postoperative state of corneal endothelium in hybrid (femtosecond laser-assisted) and torsional phacoemulsification. The study analyzed surgical outcomes of 603 patients (714 eyes) divided into 3 groups: 225 patients (267 eyes) underwent modified femtosecond laser-assisted phacoemulsification (1st group), 237 patients (278 eyes) underwent standard femtosecond laser-assisted phacoemulsification (2nd group), and 141 patients (169 eyes) who underwent torsional phacoemulsification (3rd group). The follow-up period lasted up to 2 years. In patients with grade II lens density (here and further - L. Buratto classification is used), effective ultrasound time was 0.56±0.11 s in the 1st group, 0.83±0.17 s in the 2nd group, and 2.78 ± 0.51 s in the 3rd group (p(1-2)<0.05; p(1-3)<0.05; p(2-3)<0.05). In patients with grade III lens density effective ultrasound time was 2.04±0.37 s in the 1st group, 2.97±0.53 s in the 2nd group, and 4.59±0.91 s in the 3rd group (p(1-2)<0.05; p(1-3)<0.05; p(2-3)<0.05). In patients with grade IV lens density, effective ultrasound time was 3.95±0.81 s in the 1st group, 5.11±1.03 s in the 2nd group, and 8.37±1.73 s in the 3rd group (p(1-2)<0.05; p(1-3)<0.05; p(2-3)<0.05). In patients with grade II lens density, loss of endothelial cells was 3.3±1.1% in the 1st group, 3.7±1.2% in the 2nd group, and 4.3±1.2% in the 3rd group (p(1-2)>0.05; p(1- 3)<0.05; p(2-3)<0.05). In patients with grade III lens density, loss of endothelial cells was 5.1±1.4% in the 1st group, 5.7±1.5% in the 2nd group, 7.2±1.7% in the 3rd group (p(1-2)>0.05; p(1-3)<0.05; p(2-3)<0.05). In patients with grade IV lens density, loss of endothelial cells was 8.9±2.1% in the 1st group, 10.1±2.3% in the 2nd group, and 13.3±2.5% in the 3rd group (p(1-2)>0.05; p(1-3)<0.05; p(2- -3)<0.05). Both techniques of femtosecond laser-assisted phacoemulsification significantly reduce the effective ultrasound time (p<0.05) and the degree of corneal endothelial cells loss (p<0.05) compared with torsional phacoemulsification.

South American Values of the Optical Straylight Function.

Purpose: To access retinal straylight in a Brazilian sample and to compare it with European norms. Methods: Absolute Straylight was assessed using C-Quant that uses an adaptive staircase based on a 2-Alternated Forced Choice task. A young (22.2 ± 2.4 yrs, n = 20) and an old group (53.8 ± 7.4 yrs, n = 21) of subjects were tested. All refractive errors were corrected in the C-Quant device, and no subjects had ocular diseases or vision-threatening conditions (e.g., diabetes, unregulated blood pressure, high intraocular pressure, visible cataract). Eighty-five percent of all subjects in each age group had dark-pigmented eyes. Each eye was tested 3 times, yielding 6 straylight values (s). Only data fulfilling C-Quant reliability criteria were included. Results: There were no statistical differences between the three attempts on each eye (ANOVA, F = 0.993, p > 0.936) and between the two groups (ANOVA, F = 0.893, p > 0.725). Straylight values (s) were fit with an empirical equation to compare to European norms. There were no statistical differences between Brazilian straylight values and European norms for either young or old age groups (ANOVA, F = 5.114, p > 0.993). However, there was a tendency for our s values to be higher than the European norms, consistent with young Brazilian eyes having more light-scattering than age-matched European eyes. Conclusions: Consistent with European norms, light-scattering increases with age in the Brazilian sample. This increase is thought to be due, in large part, to age-related changes in lens structure and density. Although the differences between the populations are not significant, the tendency for Brazilian data to have higher s values than European values, especially at young subjects, is in the opposite direction from that expected from a dark-eyed population. This suggests the hypothesis that latitude-dependent (Sao Paulo, latitude 23° S, European latitudes between 40° N to 55° N) differences in the light environment could be associated with differences in s values.

Average lens density quantification with swept-source optical coherence tomography: optimized, automated cataract grading technique

To assess a revised version of an objective cataract grading method based on the lens densitometry on swept-source optical coherence tomography (SS-OCT) scans. Rothschild Foundation, Paris, France. Prospective case series. All patients seeking a cataract evaluation and consenting to study participation were included. Exclusion criteria were a history of ocular surgery, cornea or retina disorders, and ocular dryness. The average lens densitometry (ALD) was measured on SS-OCT scans (IOLMaster 700) using an algorithm developed with MATLAB software. The ocular scatter index (OSI), measured using a double-pass aberrometer (Optical Quality Analysis System); Pentacam nucleus staging (PNS) score; and mean PNS were also measured and compared with the ALD measurements. Two hundred eighty-five eyes (195 with cataract; 90 controls) of 155 patients aged 20 to 93years (mean 56.5years±21 [SD]) were included. The ALD measurements were repeatable (P=.99, analysis of variance). The repeatability limit was 2.50 pixel units. The ALD correlated with the OSI (r2=0.41, P<.01) and PNS score (r2=0.65, P<.01). An ALD greater than 73.8 pixel units was the cutoff threshold for cataract, with 96.2% sensitivity and 91.3% specificity. Discriminant analysis produced a model combining visual acuity and the mean ALD with an area under the receiver operating characteristic curve of 0.975 (P<.001), where the mean ALD had the highest coefficient. Using the automated algorithm based on SS-OCT ALD measurements was a repeatable, reliable objective cataract grading method. When the ALD is greater than 73.8 pixel units, it is reasonable to discuss cataract surgery in symptomatic patients.

Assessment of Corneal and Lens Density in Children With Celiac Disease.

To assess the early changes of corneal and lens density in a pediatric population with celiac disease. One hundred one patients were included in this observational and prospective study. Patients with celiac disease formed the celiac disease group. Healthy individuals with no medical history formed the control group. Corneal and lens density were assessed with Pentacam HR (Oculus Optikgeräte GmbH, Wetzlar, Germany). The mean lens and corneal density outcomes in all zones did not differ between groups (P > .05 for each). Maximum lens density outcome was significantly higher in the celiac disease group than in the control group (P = .028). The mean corneal density at the peripheral cornea was significantly higher in females than males in the celiac disease group (P < .05 for each). Compliance with a gluten-free diet, body mass index, and histological classification of celiac disease had no significant effect on lens and corneal density in patients with celiac disease (P > .05 for each). Celiac disease did not affect the mean lens and corneal density in this pediatric population, but higher maximum lens density in patients with celiac disease and higher peripheral corneal density in female patients with celiac disease may indicate early stages of ocular involvement of celiac disease. [J Pediatr Ophthalmol Strabismus. 2019;56(6):402-406.].

Dysfunctional Lens Index Serves as a Novel Surgery Decision-Maker for Age-Related Nuclear Cataracts

ABSTRACTPurpose: To study the correlations between subjective and objective cataract metrics with dysfunctional lens index. To investigate the potential of the DLI as a novel surgery decision-maker.Methods: In this prospective, cross-sectional study, we measured the dysfunctional lens index (DLI), Lens Opacities Classification System III nuclear opalescence (LOCS III NO) grading, preoperative corrected distance visual acuity (CDVA), objective scatter index (OSI) and Scheimpflug-based average lens density (ALD) in eyes with nuclear cataract. Eyes were classified as Surgical and Non-Surgical groups. Correlations among the DLI, OSI, ALD, LOCS III NO grading, and preoperative CDVA were analyzed. The receiver operating characteristic (ROC) curve analysis was performed for DLI, OSI, and CDVA to determine optimal cut-off values to separate between surgical and non-surgical cataracts.Results: The DLI showed the strongest correlation with the OSI (r= −0.712, P< .001), followed by LOCS III NO score (r= −0.661, P< .001), ALD (r= −0.596, P< .001) and preoperative CDVA (r= 0.563, P< .001). The area under ROC curves (AUCs) of the DLI, OSI and preoperative CDVA curve were 0.972, 0.912 and 0.844 (All P< .001), respectively. The DLI cut-off value of 5.7 implied higher levels of sensitivity (91.67%) and specificity (91.84%) than the OSI cut-off value of 2.9 and the CDVA cut-off value of 0.55 (sensitivity of 89.58% and 71.92%; specificity of 81.63% and 85.71%, respectively).Conclusion: The surgery criterion of DLI ≤ 5.7 behaved better than the surgery criterions of OSI ≥ 2.9 and preoperative CDVA ≤ 0.55 in discrimination between surgical and non-surgical nuclear cataracts.

Impact of lens density and lens thickness on cumulative dissipated energy in femtosecond laser-assisted cataract surgery.

To evaluate the required cumulative dissipated energy (CDE) to fragment the crystalline lens in femtosecond laser-assisted cataract surgery (FLACS) in relation to lens density and lens thickness. Consecutive eyes that underwent FLACS between September 2014 and March 2017 by a single surgeon using in all cases the same femtosecond laser and phacoemulsification platform were included in our retrospective study. Prior to surgery, corrected distance visual acuity (CDVA), optical biometry corneal, and crystalline lens tomographies were performed to assess anterior chamber depth (ACD), axial length (AL), and crystalline lens parameters (i.e., lens density, thickness, and nucleus staging (NS)). After surgery, CDE was calculated and analyzed in relation to lens density (LD) and lens thickness (LT). Zero ultrasound expenditure cases were recorded and their occurrence analyzed. The chart review identified 236 eyes of 200 patients, 98 males and 102 females aged 65± 15years which were included in the study. Mean LD was 11.26 ± 2.05 pixel intensity units (range 7.30-18.80), and the mean LT was 3417 ± 405.17μm (range 2545-4701). LD and LT correlated moderately (r = 0.50, p < 0.001) and weakly (r = 0.23, p < 0.001), with post-laser CDE. Higher LD and LT were also associated with lower rates of zero phaco (eyes in which no phacoemulsification energy was necessary). Furthermore, NS (r = 0.528, p < 0.001) and CDVA (r = - 0.3524, p < 0.001) also correlated with CDE. Higher LD, LT, NS values, and low CDVA are associated with higher ultrasound expenditure (CDE-cumulative dissipated energy) and with lower rates of zero ultrasound expenditure during FLACS.

Evaluation of corneal and lens density changes after cross-linking in keratoconus

Background Corneal cross-linking (CXL) is an important modality for keratoconus therapy. Lens and corneal density are reported to change in keratoconus and with CXL. However, these changes are not well studied. Aim The aim of this study was to evaluate the changes in corneal and lens density in patients with keratoconus after corneal CXL. Patients and methods This is a prospective case series study that was conducted in a private Eye Laser Center, Menoufia Governorate, Egypt. The study consisted of patients with bilateral clinical keratoconus whose age ranging between 15 and 40 years with clear lenses. Bilateral minimum corneal thickness of 400 µm, measured with Pentacam, was essential. All study patients were examined preoperatively and 1, 3, and 6 months postoperatively. Ophthalmic examination included uncorrected distance visual acuity, corrected distance visual acuity, and manifest refraction as well as corneal thickness, thinnest location, maximal keratometric reading (Kmax), and corneal and lens densitometry measured by Pentacam. Results The preoperative mean corneal density on the axis 0–180 was 17.3±1.8, which changed to 20.7±2.01 after 6 months postoperatively (P=0.001). Although the preoperative mean corneal density on the axis of 90–270 was 17.4±2.06, it changed to 19.9±2.4 after 6 months postoperatively (P=0.04). No significant changes were encountered in lens density after CXL. Conclusion Corneal CXL significantly increased the corneal but not the lens density. This increase was maximal after 1 month and gradually returned toward the baseline. CXL is considered as a safe procedure for the lens.

The Change of Accommodative Functions by Difference Density and Color

Purpose : This study was to investigate the change of accommodative functions by different color density and color of colored lenses.Methods : Participant had a normal NPC and no dyschromatopsia, phoria and eye disease, also had no histories of eye surgery in 31 students of university. Their accommodative functions were measured according to 50%, 80% density of the gray, blue, brown lens and non-colored lenses. Tests of accommodative functions performed include amplitude of accommodation, accommodative facility, relative accommodation, and accommodative lag.Results : The amplitude of accommodation and accommodation lag were increased when wearing the colored lens. Negative relative accommodation was more increased when wearing the colored lens than achromatic. Positive relative accommodation increased when wearing the blue color lens density by 50%. Also, accommodation facility increased when wearing the colored lens, but, as the density of the color increased, the accommodation facility was decreased.Conclusion : As since the accommodation function changes according to density of the colored lenses, working distance and environment of the wearing colored lens should be considered when selecting density and color of colored lenses.

Дифференцированный подход к применению фемтосекундного лазера у больных возрастной катарактой с разной степенью плотности хрусталика

Дифференцированный подход к применению фемтосекундного лазера у больных возрастной катарактой с разной степенью плотности хрусталика

This issue of ACTA

This issue of <i>ACTA</i>

Intra-correlations between cataract density based on Scheimpflug image, phacodynamics, surgery duration, and endothelial cell loss after phacoemulsification

PurposeTo assess intra-correlations between lens density based-on Scheimpflug Imaging System, power used during surgery, surgery duration, and endothelial cell loss in eyes with nuclear cataract. SettingDepartment of Ophthalmology, King Fahd Hospital of the University, Alkhobar, Saudi Arabia. DesignProspective cross-sectional observational study. Methods and materialThe objective lens density and endothelial cell density were measured using the Scheimpflug system and specular microscopy, respectively. Intra-operatively, all phacodynamic parameters and duration of the surgery were documented. ResultsThis study of 62 patients (71 eyes) with a mean age of 58.56 ± 10.4 years. The mean Scheimpflug-measured lens density was 13.93 ± 3.27. The mean phacodynamic parameters, namely, power, ultrasound time, and elliptical motion were 13.63 ± 6.38, 1.27 ± 1.12, and 50.56 ± 50.06, respectively. There were a positive linear correlations between the Scheimpflug-measured lens density and phacodynamic parameters, power (AVG %), ultrasound time, and elliptical motion (r = 0.501, r = 0.620, and r = 0.641, respectively; all P < .001), amount of endothelial loss (r = 0.445, P < .001), and surgery duration (r = 0.346; P < .01). Phacodynamic parameters were positively correlated with degree of endothelial loss (P < .01). The length of the surgery failed to show any correlation with damage happened to the endothelium (r = 0.210, P > .05). ConclusionA positive correlations were observed between Scheimpflug-measured lens density with phacodynamic parameters, surgery duration, and endothelial loss. A strong correlation was observed between the degree of endothelial cell loss and phacodynamic parameters but not with the length of the procedure.

Comparability of subjective and objective measurements of nuclear density in cataract patients

To evaluate the relationship between subjective and objective measurements of lens density and the energy of phacoemulsification. University Eye Clinic, Maastricht University Medical Centre, Maastricht, the Netherlands. Cross-sectional study. The study population included 69 patients. Nuclear opalescence (NO) was graded with the Lens Opacities Classification System III (LOCS III). Thereafter, lens density was measured objectively with Scheimpflug imaging, anterior segment optical coherent tomography and spectral fundus reflectometry (SFR). Cumulative dissipative energy (CDE) and total ultrasound time (US t.t.) of the phacoemulsification were noted. The relationship between the different measurement techniques and energy of phacoemulsification was assessed using Spearman's correlation coefficients. We found moderate to strong correlations between LOCS III and objective measurements of the lens density (rho's from 0.53 to 0.78, p<0.05) and a moderate correlation between three objective measurement techniques (rho's between 0.29 and 0.57, p<0.05). There was a moderate correlation between CDE, US t.t. and lens density measurements (rho's from 0.29 to 0.55, p<0.05), and the highest correlation was found between CDE and NO scores. Exclusion of patients with advanced cortical and posterior subcapsular opacities improved the correlation between SFR and lens density measurements but not the correlation with the energy of phacoemulsification. Lens Opacities Classification System III has shown the highest correlation with phacoemulsification energy and may be a preferred technique for prediction of use of phacoemulsification energy. Advanced cortical and posterior opacities may interfere with the quality of objective measurements but do not affect the correlation between lens density measurements and phacoemulsification energy.

Age-related changes in ON and OFF responses to luminance increments and decrements.

Impulse response functions for an incremental luminous pulse (ON flash) or a decremental luminous pulse (OFF flash) were derived for twelve young (19-24 years old) and ten old (65-84 years old) observers. Thresholds were measured for two pulses separated by stimulus-onset-asynchronies from 13.3 to 186.7 ms. The pulses had a spatial Gaussian shape and were presented as increments or decrements on a 15 cd/m2 equal-energy white background, having the same chromaticity as the pulse. A spatial four-alternative forced-choice method was combined with a staircase procedure. Retinal illuminance was equated individually by heterochromatic flicker photometry and using a 2.3-mm exit pupil in a Maxwellian-view optical system to reduce the effects of age-related changes and individual variations in lens density and pupil size. Luminance ON- and OFF-impulse response functions calculated from the threshold data revealed significant age-related changes in the response amplitude of both first excitatory and first inhibitory phases. However, there were no significant changes in the time to the first peak or the second peak. These age-related changes in luminance varying ON- and OFF-impulse response functions (IRFs), reflecting putative properties of the magnocellular pathway, are discussed in relation to motion detection and the balance of ON and OFF pathways across the life span.

Comparison of 2 laser fragmentation patterns used in femtosecond laser–assisted cataract surgery

To evaluate the effect of fragmentation patterns (pie pattern versus grid pattern) on effective phacoemulsification time (EPT). Department of Ophthalmology, Goethe University, Frankfurt am Main, Germany. Retrospective case series. Eyes that had femtosecond laser-assisted cataract surgery were included. One half of the group was treated with the pie pattern. The preoperative lens density was evaluated by Scheimpflug imaging (Pentacam). Then, the eyes treated with the grid pattern were matched to the pie-pattern group based on lens density (Scheimpflug imaging). The study comprised 150 eyes (75 in the pie-pattern group and 75 in the grid pattern group). The mean patient age was 66years±10.67 (SD). The Scheimpflug density zone was 10.05%±1.52%. The mean EPT was 6.63±5.41seconds for the pie pattern, significantly higher than the 4.26±6.99seconds for the grid pattern (P<.01, Wilcoxon rank-sum test). The number of eyes with EPT=0 was significantly higher with grid pattern (37 for grid versus 1 for pie, P<.01, χ2 test). Regression analysis showed that the EPT was significantly dependent on lens density for both methods (P=.045 for pie versus P<.01 for grid). In eyes with a lens density higher than 12% (9 eyes in each group), the pie pattern showed significantly lower EPT (P=.02, Wilcoxon rank-sum test). In cases of low to moderate lens density, grid fragmentation pattern should be used because the EPT was significantly lower and a significantly higher number of eyes did not require further emulsification. However, in eyes with high density (>12%), pie-pattern fragmentation is recommended.

New objective lens density quantification method using swept-source optical coherence tomography technology: Comparison with existing methods

To assess a new objective cataract grading method based on lens densitometry on swept-source optical coherence tomography (SS-OCT) scans provided by the IOLMaster700. Rothschild Foundation, Paris, France. Prospective case series. All patients consulting for cataract evaluation who provided their consent to participate in the study were included. A history of eye surgery, corneal or retinal disorders, and ocular dryness were exclusion criteria. The average lens densitometry was measured with SS-OCT scans using ImageJ software. The ocular scatter index (OSI) measured with a double-pass aberrometer (Optical Quality Analysis System), the Pentacam nucleus staging (hereafter referred to as nuclear staging) score, and mean nuclear staging were also measured and compared with the mean lens densitometry. One hundred ten eyes (51 with cataract and 59 controls) were included. The average lens densitometry measurements were repeatable (P=.99, analysis of variance). The repeatability limit was 2.50 pixel units. The average lens density was correlated with the OSI (r2=0.52, P<.01), nuclear staging score (r2=0.75, P<.01), and mean nuclear staging (r2=0.41, P<.01). An average lens density greater than 82.9 pixel units was the cutoff threshold for cataract, with a sensitivity of 73.9% and a specificity of 91.2%. The average lens density measured by SS-OCT was a repeatable and reliable objective cataract grading method. It was correlated with OSI measurement. If the average lens density was greater than 82.9 pixel units and the patient reported visual impairment, cataract surgery might be discussed.

On the choice of lens density profile in time delay cosmography

Time delay lensing is a mature and competitive cosmological probe. However, it is limited in accuracy by the well-known problem of the mass-sheet degeneracy: too rigid assumptions on the density profile of the lens can potentially bias the inference on cosmological parameters. I investigate the degeneracy between the choice of the lens density profile and the inference on the Hubble constant, focusing on double image systems. By expanding lensing observables in terms of the local derivatives of the lens potential around the Einstein radius, and assuming circular symmetry, I show that three degrees of freedom in the radial direction are necessary to achieve a few percent accuracy in the time-delay distance. Additionally, while the time delay is strongly dependent on the second derivative of the potential, observables typically used to constrain lens models in time-delay studies, such as image position and radial magnification information, are mostly sensitive to the first and third derivatives, making it very challenging to accurately determine time-delay distances with lensing data alone. Tests on mock observations show that the assumption of a power-law density profile results in a 5% average bias on $H_0$, with a 6% scatter. Using a more flexible model and adding unbiased velocity dispersion constraints allows to obtain an inference with 1% accuracy. A power-law model can still provide 3% accuracy if velocity dispersion measurements are used to constrain its slope. Although this work is based on the assumption of axisymmetry, its main findings can be generalized to cases with moderate ellipticity.

Wavefront aberrations and retinal image quality in different lenticular opacity types and densities

To investigate wavefront aberrations in the entire eye and in the internal optics (lens) and retinal image qualities according to different lenticular opacity types and densities. Forty-one eyes with nuclear cataract, 33 eyes with cortical cataract, and 29 eyes with posterior subcapsular cataract were examined. In each group, wavefront aberrations in the entire eye and in the internal optics and retinal image quality were measured using a raytracing aberrometer. Eyes with cortical cataracts showed significantly higher coma-like aberrations compared to the other two groups in both entire eye and internal optic aberrations (P = 0.012 and P = 0.007, respectively). Eyes with nuclear cataract had lower spherical-like aberrations than the other two groups in both entire eye and internal optics aberrations (P < 0.001 and P < 0.001, respectively). In the nuclear cataract group, nuclear lens density was negatively correlated with internal spherical aberrations (r = −0.527, P = 0.005). Wavefront technology is useful for objective and quantitative analysis of retinal image quality deterioration in eyes with different early lenticular opacity types and densities. Understanding the wavefront optical properties of different crystalline lens opacities may help ophthalmic surgeons determine the optimal time to perform cataract surgery.

The quantitative assessment of alterations in lens transparency after transconjunctival 27-gauge microincision vitrectomy surgery.

PurposeTo evaluate the baseline and post-vitrectomy lens densitometry values by a Scheimpflug camera in eyes with epiretinal membrane that were treated with 27-G microincision vitrectomy surgery (MIVS) without tamponade and to compare the results with those in fellow healthy eyes.Patients and methodsProspective case series. The lens densitometry measurements of 24 patients, who underwent 27-G MIVS without any tamponade for the treatment of epiretinal membrane, were taken preoperatively and on the first week, first month, and third month postoperatively with Pentacam HR-Scheimpflug imaging system.ResultsThe mean lens densitometry values at Zone 1 and average lens densitometry values significantly increased in the study eyes on the first month when compared with the preoperative values (P=0.011, P=0.033, respectively). Additionally, there were statistically significant differences regarding the mean lens densitometry values of Zone 1 and Zone 2, and also average lens densitometry values between the preoperative and third month postoperative values (P=0.003, P=0.021, P=0.009, respectively). However, the densitometry values of fellow eyes were similar at preoperatively and all the postoperative follow-up periods (P>0.05 for all).ConclusionsThis study suggests that 27-G MIVS might cause post-surgical lens density changes even in early postoperative months and vitreous may play an important role in protecting the transparency of the lens.

Imaging Lenticular Autofluorescence in Older Subjects.

PurposeTo evaluate whether a practical method of imaging lenticular autofluorescence (AF) can provide an individualized measure correlated with age-related lens yellowing in older subjects undergoing tests involving shorter wavelength lights.MethodsLenticular AF was imaged with 488-nm excitation using a confocal scanning laser ophthalmoscope (cSLO) routinely used for retinal AF imaging. There were 75 older subjects (ages 47–87) at two sites; a small cohort of younger subjects served as controls. At one site, the cSLO was equipped with an internal reference to allow quantitative AF measurements; at the other site, reduced-illuminance AF imaging (RAFI) was used. In a subset of subjects, lens density index was independently estimated from dark-adapted spectral sensitivities performed psychophysically.ResultsLenticular AF intensity was significantly higher in the older eyes than the younger cohort when measured with the internal reference (59.2 ± 15.4 vs. 134.4 ± 31.7 gray levels; P < 0.05) as well as when recorded with RAFI without the internal reference (10.9 ± 1.5 vs. 26.1 ± 5.7 gray levels; P < 0.05). Lenticular AF was positively correlated with age; however, there could also be large differences between individuals of similar age. Lenticular AF intensity correlated well with lens density indices estimated from psychophysical measures.ConclusionsLenticular AF measured with a retinal cSLO can provide a practical and individualized measure of lens yellowing, and may be a good candidate to distinguish between preretinal and retinal deficits involving short-wavelength lights in older eyes.