{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T15:17:07Z","timestamp":1777130227256,"version":"3.51.4"},"reference-count":58,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T00:00:00Z","timestamp":1679616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Retromode is a relatively new retinal-imaging technique that is based on the transillumination principle and is obtained with a scanning laser ophthalmoscope that uses light in the infrared spectrum. The laser light penetrates into the deep retinal layers and the choroid. Retromode images are captured with a laterally displaced aperture, and the detector captures only the scattered light. The result is a high-contrast pseudo-three-dimensional image. Age-related macular degeneration (AMD) is a disabling retinal disease. AMD is characterized in its early stage by small and intermediate drusen formation, while the signs of intermediate AMD are large drusen and\/or pigmentary abnormalities. Late AMD has two forms, geographic atrophy, which is the advanced form of dry AMD, and wet AMD. Most of the lesions of AMD are located in the outer layers of the retina. This new imaging method can provide a glimpse of the deep retinal layers\u2019 topographic changes in a non-invasive, fast, and effective way that can match the other imaging tools available. Materials and Methods: The literature review was performed by searching the PubMed database using the following combination of keywords: retromode imaging and age-related macular degeneration. Relevant images similar to the ones in the literature were identified and used as models. Results: The purpose of this article is to highlight the utility of incorporating retromode imaging into the multimodal evaluation of the retina in patients with AMD and to gather and integrate these findings into a brief but comprehensive paper. Conclusions: Retromode imaging is a good screening, diagnosis, and monitoring tool for patients with AMD.<\/jats:p>","DOI":"10.3390\/medicina59040647","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T04:31:05Z","timestamp":1679632265000},"page":"647","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Retromode Imaging in Age-Related Macular Degeneration"],"prefix":"10.3390","volume":"59","author":[{"given":"Antonia-Elena","family":"Ranetti","sequence":"first","affiliation":[{"name":"Doctoral School, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucure\u0219ti, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2595-6319","authenticated-orcid":false,"given":"Horia Tudor","family":"Stanca","sequence":"additional","affiliation":[{"name":"Doctoral School, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucure\u0219ti, Romania"},{"name":"Clinical Department of Ophthalmology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bogdana","family":"T\u0103b\u0103caru","sequence":"additional","affiliation":[{"name":"Clinical Department of Ophthalmology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Teodoru","sequence":"additional","affiliation":[{"name":"Clinical Surgical Department, Faculty of Medicine, \u201cLucian Blaga\u201d University Sibiu, 550169 Sibiu, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihnea","family":"Munteanu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Stanca","sequence":"additional","affiliation":[{"name":"Clinical Department of Pediatrics, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 020021 Bucure\u0219ti, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1016\/S0140-6736(18)31550-2","article-title":"Age-related macular degeneration","volume":"392","author":"Mitchell","year":"2018","journal-title":"Lancet"},{"key":"ref_2","unstructured":"GBD 2019 Blindness, Vision Impairment Collaborators, and the Vision Loss Expert Group of the Global Burden of Disease Study (2021). Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: The Right to Sight: An analysis for the Global Burden of Disease Study. Lancet Glob. Health, 9, e144\u2013e160. Erratum in 2021, 9, e408."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1016\/j.ophtha.2020.11.024","article-title":"Genetic Risk, Lifestyle, and Age-Related Macular Degeneration in Europe","volume":"128","author":"Colijn","year":"2020","journal-title":"Ophthalmology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1016\/j.ophtha.2012.10.036","article-title":"Clinical Classification of Age-related Macular Degeneration","volume":"120","author":"Ferris","year":"2013","journal-title":"Ophthalmology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S15","DOI":"10.1016\/j.ophtha.2009.06.048","article-title":"Antiangiogenic Approaches to Age-Related Macular Degeneration Today","volume":"116","author":"Bressler","year":"2009","journal-title":"Ophthalmology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.survophthal.2012.01.006","article-title":"Evaluation of Age-related Macular Degeneration With Optical Coherence Tomography","volume":"57","author":"Keane","year":"2012","journal-title":"Surv. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.ophtha.2019.09.035","article-title":"Incomplete Retinal Pigment Epithelial and Outer Retinal Atrophy in Age-Related Macular Degeneration","volume":"127","author":"Guymer","year":"2019","journal-title":"Ophthalmology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2371","DOI":"10.1097\/IAE.0000000000000716","article-title":"Optical coherence tomography angiography features of diabetic retinopathy","volume":"35","author":"Hwang","year":"2015","journal-title":"Retina"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/S0161-6420(02)01756-6","article-title":"Fundus autofluorescence and age-related macular degeneration","volume":"110","author":"Spaide","year":"2003","journal-title":"Ophthalmology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1136\/bjo.79.5.407","article-title":"Distribution of fundus autofluorescence with a scanning laser ophthalmoscope","volume":"79","author":"Fitzke","year":"1995","journal-title":"Br. J. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/s40942-022-00421-0","article-title":"Scanning laser ophthalmoscopy retroillumination: Applications and illusions","volume":"8","author":"Mainster","year":"2022","journal-title":"Int. J. Retin. Vitr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1001\/archopht.1960.01840010608020","article-title":"The Loss of Light Energy in Retina and Choroid","volume":"64","author":"Geeraets","year":"1960","journal-title":"Arch. Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e404","DOI":"10.1111\/j.1755-3768.2011.02123.x","article-title":"Drusen detection in retro-mode imaging by a scanning laser ophthalmoscope","volume":"89","author":"Acton","year":"2011","journal-title":"Acta Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1136\/bjophthalmol-2012-302575","article-title":"Drusen detection by confocal aperture-modulated infrared scanning laser ophthalmoscopy","volume":"97","author":"Diniz","year":"2012","journal-title":"Br. J. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.sjopt.2014.02.003","article-title":"Retromode imaging: Review and perspectives","volume":"28","author":"Lee","year":"2014","journal-title":"Saudi J. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1136\/bjo.76.8.470","article-title":"Confocal imaging of the fundus using a scanning laser ophthalmoscope","volume":"76","author":"Woon","year":"1992","journal-title":"Br. J. Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1016\/j.ophtha.2010.11.013","article-title":"Spectral Domain Optical Coherence Tomography Imaging of Drusen in Nonexudative Age-Related Macular Degeneration","volume":"118","author":"Gregori","year":"2011","journal-title":"Ophthalmology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"AMD48","DOI":"10.1167\/iovs.18-24158","article-title":"Multimodal Imaging of Nonneovascular Age-Related Macular Degeneration","volume":"59","author":"Garrity","year":"2018","journal-title":"Investig. Opthalmology Vis. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.survophthal.2007.08.022","article-title":"Use of Fundus Imaging in Quantification of Age-related Macular Change","volume":"52","author":"Bartlett","year":"2007","journal-title":"Surv. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.ophtha.2006.10.040","article-title":"Fifteen-Year Cumulative Incidence of Age-Related Macular Degeneration: The Beaver Dam Eye Study","volume":"114","author":"Klein","year":"2007","journal-title":"Ophthalmology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1001\/archopht.123.11.1570","article-title":"A simplified severity scale for age-related macular degeneration: AREDS Report No. 18","volume":"123","author":"Ferris","year":"2005","journal-title":"Arch. Ophthalmol. (Chic. Ill 1960)"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.ophtha.2006.07.017","article-title":"Ten-Year Incidence and Progression of Age-Related Maculopathy: The Blue Mountains Eye Study","volume":"114","author":"Wang","year":"2007","journal-title":"Ophthalmology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1097\/IAE.0b013e31829d0015","article-title":"Drusen measurements comparison by fundus photograph manual delineation versus optical coherence tomography retinal pigment epithelial segmentation automated analysis","volume":"34","author":"Diniz","year":"2014","journal-title":"Retina"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/j.oret.2020.04.013","article-title":"Sensitivity and Specificity of Multimodal Imaging in Characterizing Drusen","volume":"4","author":"Cozzi","year":"2020","journal-title":"Ophthalmol. Retin."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.ophtha.2020.09.038","article-title":"Subretinal Drusenoid Deposits Revealed by Color SLO and Retro-Mode Imaging","volume":"128","author":"Corradetti","year":"2021","journal-title":"Ophthalmology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1016\/j.oret.2021.05.005","article-title":"Reticular Pseudodrusen: Detecting a Common High-Risk Feature in Age-Related Macular Degeneration","volume":"5","author":"Holz","year":"2021","journal-title":"Ophthalmol. Retin."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1016\/j.ophtha.2010.01.027","article-title":"Prevalence and Significance of Subretinal Drusenoid Deposits (Reticular Pseudodrusen) in Age-Related Macular Degeneration","volume":"117","author":"Zweifel","year":"2010","journal-title":"Ophthalmology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4267","DOI":"10.1167\/iovs.15-16657","article-title":"Foveal Sparing of Reticular Drusen in Eyes With Early and Intermediate Age-Related Macular Degeneration","volume":"56","author":"Steinberg","year":"2015","journal-title":"Investig. Opthalmology Vis. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/j.ajo.2014.01.025","article-title":"Pseudodrusen Subtypes as Delineated by Multimodal Imaging of the Fundus","volume":"157","author":"Suzuki","year":"2014","journal-title":"Am. J. Ophthalmol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1097\/IAE.0b013e318276e0ae","article-title":"Sensitivity and specificity of detecting reticular pseudodrusen in multimodal imaging in Japanese patients","volume":"33","author":"Ooto","year":"2013","journal-title":"Retina"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e246","DOI":"10.1111\/aos.12948","article-title":"Reticular pseudodrusen characterization by retromode imaging","volume":"95","author":"Parravano","year":"2016","journal-title":"Acta Ophthalmol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.preteyeres.2009.08.003","article-title":"The dynamic nature of Bruch\u2019s membrane","volume":"29","author":"Booij","year":"2010","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.2147\/CIA.S143508","article-title":"Recent developments in age-related macular degeneration: A review","volume":"12","author":"Yassin","year":"2017","journal-title":"Clin. Interv. Aging"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1111\/ceo.13834","article-title":"Retinal pigment epithelium and age-related macular degeneration: A review of major disease mechanisms","volume":"48","author":"Somasundaran","year":"2020","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"16252","DOI":"10.1038\/s41598-021-95320-z","article-title":"In vivo multimodal retinal imaging of disease-related pigmentary changes in retinal pigment epithelium","volume":"11","author":"Meleppat","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.ajo.2012.01.023","article-title":"Retro-mode Imaging for Retinal Pigment Epithelium Alterations in Central Serous Chorioretinopathy","volume":"154","author":"Shin","year":"2012","journal-title":"Am. J. Ophthalmol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Giansanti, F., Mercuri, S., Serino, F., Caporossi, T., Savastano, A., Rizzo, C., Faraldi, F., Rizzo, S., and Bacherini, D. (2022). Scanning Laser Ophthalmoscopy Retromode Imaging Compared to Fundus Autofluorescence in Detecting Outer Retinal Features in Central Serous Chorioretinopathy. Diagnostics, 12.","DOI":"10.3390\/diagnostics12112638"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1097\/IAE.0b013e3182993f66","article-title":"Multimodal imaging of pigment epithelial detachment: A guide to evaluation","volume":"33","author":"Mrejen","year":"2013","journal-title":"Retina"},{"key":"ref_39","unstructured":"Gass, J. (1970). Stereoscopic Atlas of Macular Diseases, CV Mosby. [1st ed.]."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/S0039-6257(05)80092-X","article-title":"An international classification and grading system for age-related maculopathy and age-related macular degeneration","volume":"39","author":"Bird","year":"1995","journal-title":"Surv. Ophthalmol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1016\/S0161-6420(99)90340-8","article-title":"Enlargement of atrophy and visual acuity loss in the geographic atrophy form of age-related macular degeneration","volume":"106","author":"Sunness","year":"1999","journal-title":"Ophthalmology"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2042","DOI":"10.1016\/j.ophtha.2013.03.029","article-title":"Incidence and Progression of Geographic Atrophy","volume":"120","author":"Joachim","year":"2013","journal-title":"Ophthalmology"},{"key":"ref_43","first-page":"361","article-title":"Natural History of Geographic Atrophy Progression Secondary to Age-Related Macular Degeneration (Geographic Atrophy Progression Study)","volume":"123","author":"Sahel","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1038\/s41433-021-01670-3","article-title":"Retro mode illumination for detecting and quantifying the area of geographic atrophy in non-neovascular age-related macular degeneration","volume":"36","author":"Corradetti","year":"2021","journal-title":"Eye"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s00417-012-2031-7","article-title":"Confocal scanning laser ophthalmoscope in the retromode imaging modality in exudative age-related macular degeneration","volume":"251","author":"Pilotto","year":"2012","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/j.oret.2019.04.018","article-title":"Anti\u2013Vascular Endothelial Growth Factor Resistance in Exudative Macular Degeneration and Polypoidal Choroidal Vasculopathy","volume":"3","author":"Kokame","year":"2019","journal-title":"Ophthalmol. Retin."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Zeng, R., Zhang, X., Su, Y., Li, M., Wu, K., and Wen, F. (2013). The Noninvasive Retro-Mode Imaging Modality of Confocal Scanning Laser Ophthalmoscopy in Polypoidal Choroidal Vasculopathy: A Preliminary Application. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0075711"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1442-9071.2010.02193.x","article-title":"Visualization of cystoid macular oedema using a scanning laser ophthalmoscope in the retro-mode","volume":"38","author":"Yamamoto","year":"2010","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2416","DOI":"10.1097\/IAE.0000000000000262","article-title":"Extent of diabetic macular edema by scanning laser ophthalmoscope in the retromode and its functional correlations","volume":"34","author":"Vujosevic","year":"2014","journal-title":"Retina"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e374","DOI":"10.1111\/j.1755-3768.2012.02410.x","article-title":"Scanning laser ophthalmoscopy in the retromode in diabetic macular oedema","volume":"90","author":"Vujosevic","year":"2012","journal-title":"Acta Ophthalmol."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Maurizio, B.P., Pierluigi, I., Stelios, K., Stefano, V., Marialucia, C., Ilaria, Z., and Francesco, B. (2012). Retro-mode imaging and fundus autofluorescence with scanning laser ophthalmoscope of retinal dystrophies. BMC Ophthalmol., 12.","DOI":"10.1186\/1471-2415-12-8"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s10633-011-9309-7","article-title":"Bietti crystalline dystrophy: A morpho-functional evaluation","volume":"124","author":"Parravano","year":"2011","journal-title":"Doc. Ophthalmol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1038\/eye.2014.139","article-title":"The noninvasive retro-mode imaging of confocal scanning laser ophthalmoscopy in myopic maculopathy: A prospective observational study","volume":"28","author":"Su","year":"2014","journal-title":"Eye"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.ajo.2009.10.024","article-title":"Retromode Retinal Imaging of Macular Retinoschisis in Highly Myopic Eyes","volume":"149","author":"Tanaka","year":"2010","journal-title":"Am. J. Ophthalmol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"368","DOI":"10.3928\/23258160-20220614-01","article-title":"Morphological Features of Full-Thickness Macular Holes Using Retromode Scanning Laser Ophthalmoscopy","volume":"53","author":"Savastano","year":"2022","journal-title":"Ophthalmic Surg. Lasers Imaging Retin."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Savastano, A., Ripa, M., Savastano, M.C., Caporossi, T., Bacherini, D., Kilian, R., Rizzo, C., and Rizzo, S. (2022). Retromode Imaging Modality of Epiretinal Membranes. J. Clin. Med., 11.","DOI":"10.3390\/jcm11143936"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.ajo.2018.08.013","article-title":"Evaluation of Retromode Imaging for Use in Hydroxychloroquine Retinopathy","volume":"196","author":"Ahn","year":"2018","journal-title":"Am. J. Ophthalmol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1016\/j.ajo.2010.06.022","article-title":"Visualization of Subthreshold Micropulse Diode Laser Photocoagulation by Scanning Laser Ophthalmoscopy in the Retro Mode","volume":"150","author":"Ohkoshi","year":"2010","journal-title":"Am. J. Ophthalmol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/4\/647\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:02:10Z","timestamp":1760122930000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/4\/647"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,24]]},"references-count":58,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["medicina59040647"],"URL":"https:\/\/doi.org\/10.3390\/medicina59040647","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,24]]}}}