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M. R. Heldner, S. Wolf, W. Einbock, C. K. Brinkmann, U. E. K. Wolf-Schnurrbusch; Fundus Autofluorescence Pattern in Patients With Early Age-Related Maculopathy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2115.
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The fundus autofluorescence in age-related macular degeneration study group (FAM-Study group) aims at identifying autofluorescence (AF) changes as predictive factors for the progression of age-related macular degeneration (ARMD). We report changes in fundus AF pattern in patients with early age-related maculopathy (ARM) according to the Rotterdam Classification stage 1-3.
All included patients with early ARM underwent a detailed ophthalmological examination in study and fellow eyes. Examination included ETDRS visual acuity, binocular funduscopy, AF imaging, fluorescein and ICG angiography, and color fundus photography. AF imaging was performed with a confocal scanning laser ophthalmoscope (HRA, Heidelberg Engineering, Germany) following a standard protocol. AF images were analyzed for focal areas of increased or decreased fundus autofluorescence. For description of the AF distribution eight different pattern of retinal AF were defined. These included a nearly normal pattern, reticular patterns, lace like pattern, linear pattern, speckled pattern, focal-increased pattern, focal-plaque like pattern, and patchy pattern.
In total 521 patients (521 eyes) were included in this analysis. Visual acuity ranged from 20/100 to 20/20. AF pattern showed a nearly normal pattern in 16.9% eyes, reticular pattern in 24.6% eyes, lace like pattern 2.6% eyes, linear pattern in 1.5% eyes, speckled pattern in 19.5% eyes, focal-increased pattern in 9.2% pattern, focal-plaque like pattern in 3.1% eyes, and patchy pattern 22.6% eyes. The intraobserver variability of the first observer was Κ= 0.81 (95% confidence interval (CI) 0.70-0.89) and for the second observer Κ= 0.79 (95% confidence interval (CI) 0.74-0.85). The interobserver variability was Κ= 0.78 (95% confidence interval (CI) 0.67-0.88).
Imaging of fundus autofluorescence in patients with ARM allows to identify different patterns of fundus AF. There is relatively high degree of intra- and interobserver agreement. The FAF changes do not necessarily correlate topographically with visible fundus changes in patients with early ARM. Areas of increased AF may or may not correspond with areas of hyperpigmentation or soft or hard drusen.
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