purpose. To evaluate the origin of the near-infrared autofluorescence (AF) of the fundus detected by scanning laser ophthalmoscopy and compare the distribution of this AF with that of lipofuscin.

methods. AF [787] fundus images (excitation [Exc.] 787 nm; emission [Emi.]> 800 nm) were recorded with a confocal scanning laser ophthalmoscope, in 85 normal subjects (ages: 11–77 years) and in 25 patients with AMD and other retinal diseases. Standard AF [488] images (Exc. 488 nm; Emi.> 500 nm) were recorded in a subset of the population.

results. The fovea exhibits higher AF [787] than the perifovea in an area∼ 8 in diameter, roughly equivalent to the area of higher RPE melanin seen in AF [488] and color images. The ratio of foveal to perifoveal AF [787] decreases with age (P< 0.0001) and is higher in subjects with light irides (P= 0.04). Higher AF [787] emanates from hyperpigmentation, from the choroidal pigment (nevi, outer layers) and from the pigment epithelium and stroma of the iris. Low AF [787] is observed in geographic atrophy particularly in subjects with light irides.

conclusions. AF [787] originates from the RPE and to a varying degree from the choroid. Oxidized melanin, or compounds closely associated with melanin, contributes substantially to this AF, but other fluorophores cannot be excluded at this stage. Confocal AF [787] imaging may provide a new modality to visualize pathologic features of the RPE and the choroid, and, together with AF [488] imaging, offers a new tool to study biological changes associated with aging of the RPE and pathology.