Lighting Up the Retina: Fundus Autofluorescence Imaging in Retinal and Choroidal Diseases

Fundus autofluorescence (FAF) is a non-invasive imaging method that maps normal and abnormal retinal fluorophores, mainly lipofuscin. Although researched for decades, its major clinical use expanded significantly only in recent years. It has emerged as a pivotal non-invasive diagnostic tool in ophthalmology, providing insights into the metabolic activity of the retinal pigment epithelium (RPE) and adjacent structures. This review discusses principles of FAF and current evidence on FAF patterns across a spectrum of retinal and choroidal diseases, thereby highlighting its diagnostic, prognostic and monitoring utility. Advances in imaging modalities and integration with multimodal platforms continue to expand its clinical relevance.