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Ocular fluorometry: standardization and instrumentation development

Objective

1. Harmonization and standardization of the various methodologies of ocular fluorometry, through the coordination of the participating centers to enable direct comparisons of results and make them available into a common data base. The group that will carry out this work will be designated European Clinical Network of Ocular Fluorometry (ECNOF).

Development of sophisticated target-oriented instrumentation and systems as this would increase the potential of fluorometry for both endogenous and exogenous fluorophores. More specifically the need to enhance special resolution and improve spectral resolution was identified.

Identification of appropriate fluorophores and definition of directions for instrumentation and development.
The project has been set up to harmonize and standardize the various methodologies of ocular fluorometry, through the coordination of the participating centers to enable direct comparisons of results and make them available into a common data base. The group has been designated the European Clinical Network of Ocular Fluorometry (ECNOF). The achievements are as follows:
agreement on common protocols for patient examination and data gathering;
development of standardized methods, calibration procedures and protocols for the determination of several parameters using ocular fluorometry;
development and testing of specially designed software for 3 main areas of clinical measurement: anterior segment, lens, and blood retinal barrier;
establishment of adatabase of normal values for the different ocular fluorometry tests;
demonstration that ocular fluorometry measurements may be performed reliably and in a reproducible manner in different centers;
publication of a manual of ocular fluorometry;
first steps of an atlas of ocular fluorophores;
prototype development and comparisons with available instrumentation in the area of light scattering measurements in the aqueous, cornea and lens;
evaluation of the possibilities offered by spectral analysis of the native fluorescence of the cornea, lens and retina; demonstration of the immediate clinical interest of measurements of corneal and lens fluorescence, particularly in diabetic patients; a simple, totally noninvasive procedure for measuring corneal fluorescence may become a retinopathy screening in diabetic patients;
prototype development directed to improve axial resolution led to the conclusion that a target oriented modification of existing confocal scanning ophthalmoscope is the best option to improve axial resolution for the purpose of ocular fluorometry measurements.
Methodology Used

Coordination and cooperation between different centers was considered necessary in order to : 1) pool data, particularly from a normal population; 2) to integrate research progress; 3) to establish task groups on selected areas of instrumentation development; 4) to establish an European database on Ocular Fluorometry.

The objectives of the Clinical Component were achieved by general meetings, definition of protocols, design of multicenter studies, development and distribution of softwares, establishment of communication channels and small training workshops. Three specific areas, using specific software, were identified: anterior segment, lens and blood-retinal barrier. Each one of these clinical areas had a Coordinating Center (Leiden, Coimbra and Copenhagen, respectively).

The objectives of the Bioengineering component were achieved through workshops, participation in the general meetings to establish interchange between biologists, medical people and engineers, transfer and exchange of equipment and exchange of research workers between the centers that were involved in prototype development. In order to coordinate efforts four tasks were finally established in this area:

1. Development of an Atlas of Ocular Fluorophores.
2. Light Scattering Measurements in the Ocular Tissues and Fluids.
3. Spectral Fluorescence Analysis of Ocular Tissues.
4. Improved Axial Resolution for Permeability Measurements of the Ocular Barriers.

Funding Scheme

CON - Coordination of research actions

Coordinator

Coimbra University Hospital
Address

3049 Coimbra Codex
Portugal