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What is Fundus Photography?

Proper diagnosis of macular degeneration is important, because early diagnosis and treatment may help slow the progression of the disease and promote existing eye health and vision. Diagnosis is done by your eye doctor, through a comprehensive dilated eye exam that can include a variety of components, including a visual acuity test, dilated fundus exam, Amsler grid, fluorescein angiogram, and optical coherence tomography.1 Another tool your doctor might use is fundus photography.

What is fundus photography?

The fundus is the back of the eye and includes the retina, optic nerve, and retinal blood vessels. In fundus photography, the fundus is photographed with special cameras through a dilated pupil, providing a color picture of the back of the eye.2,3 The procedure is brief, only taking a minute or two, and painless.

What does a fundus photograph show?

It’s able to provide a picture of the retina, the retinal vasculature (blood vessels), and the optic nerve head, where retinal blood vessels enter the eye.2 It can also show drusen, abnormal bleeding, scar tissue, and areas of atrophy.3 In sum, it can provide your eye doctor with a visual picture of any abnormalities that may be present in the back of the eye.

Fundus photography and macular degeneration

In terms of macular degeneration, fundus photography may reveal the extent of the disease at that moment. This is especially important as the disease progresses – a series of fundus photographs can provide your doctor with a visual timeline of how it has affected your eye, as well as the severity and speed of the progression. Fundus photography is also used in other eye diseases, such as diabetic retinopathy and glaucoma.

What is fundus autofluorescence (FAF)?

Fundus autofluorescence (FAF) is similar to fundus photography but uses a blue light when the picture is taken. Certain structures in the eye absorb blue light, including lipofuscin, the waste product that builds up in RPE cells.4 This is also a marker of macular degeneration, so FAF can provide more diagnostic information to your eye doctor, as well as provide information about disease progression and treatment response.

Risks and benefits

There are little to no risks with fundus photography. You might not be able to see as clearly while your pupils are dilated for the exam and procedure, but fundus photography is not invasive and only takes a minute or two. The benefits can outweigh perceived risks, since the images obtained can help detect eye disease in early stages, allowing preventative measures to be started, as well as any possible treatments. It also provides your eye doctor with more information to monitor your disease progression, allowing him/her to plan treatment accordingly and let you know what you might expect going forward.

Combined approach to retinal imaging

Fundus photography is often used in conjunction with other modes of retinal imaging in the setting of macular degeneration. Especially with the advent of digital imaging, multiple digital imaging modalities can be used together to provide a highly detailed picture of a patient’s eye from various perspectives and different resolutions, providing a more comprehensive view of the retina.5

Monitoring macular degeneration

Talk with your eye doctor about whether she uses fundus photography in her practice, and how it might be helpful for monitoring your macular degeneration and treatment response. If they don’t use fundus photography, it might be informative to find out how your macular degeneration is being monitored and what other types of retinal imaging might be used.

Jaime R. Herndon | January 2019
  1. National Institutes of Health: National Eye Institute. Facts About Age-Related Macular Degeneration. 2015. https://nei.nih.gov/health/maculardegen/armd_facts. Accessed November 23, 2018.
  2. Carver College of Medicine. Color Fundus Photography. 2018. https://medicine.uiowa.edu/eye/patient-care/imaging-services/color-fundus-photography. Accessed November 23, 2018.
  3. Dunaief J. Retinal imaging for diagnosing and treating AMD. BrightFocus Foundation. 2018. https://www.brightfocus.org/macular/article/retinal-imaging-diagnosing-and-treating-amd. Accessed November 23, 2018.
  4. Yung M, Klufas MA, Sarraf D. Clinical applicationsof fundus autofluorescence in retinal disease. International Journal of Retina and Vitreous. 2016; 2(12). Doi:https://doi.org/10.1186/s40942-016-0035-x. Accessed February 5, 2019.
  5. Abramoff MD, Garvin MK, Sonka M. Retinal imaging and image analysis. IEEE Rev Biomed Eng. 2010; 3: 169-208. Doi: 10.1109/RBME.2010.2084567. Accessed November 23, 2018.