Monitoring macular pigment changes in macular holes using fluorescence lifetime imaging ophthalmoscopy

Purpose To investigate the impact of macular pigment (MP) on fundus autofluorescence (FAF) lifetimes in vivo by characterizing full‐thickness idiopathic macular holes (MH) and macular pseudo‐holes (MPH). Methods A total of 37 patients with MH and 52 with MPH were included. Using the fluorescence lifetime imaging ophthalmoscope (FLIO), based on a Heidelberg Engineering Spectralis system, a 30° retinal field was investigated. FAF decays were detected in a short (498–560 nm; ch1) and long (560–720 nm; ch2) wavelength channel. τm, the mean fluorescence lifetime, was calculated from a three‐exponential approximation of the FAF decays. Macular coherence tomography scans were recorded, and macular pigment's optical density (MPOD) was measured (one‐wavelength reflectometry). Two MH subgroups were analysed according to the presence or absence of an operculum above the MH. A total of 17 healthy fellow eyes were included. A longitudinal FAF decay examination was conducted in nine patients, which were followed up after surgery and showed a closed MH. Results In MH without opercula, significant τm differences (p