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Amitha Domalpally, Ronald P Danis, Emily Y Chew, Traci E Clemons; Fundus Autofluorescence Imaging and Macular Atrophy in Eyes with Neovascular Age Related Macular Degeneration in AREDS2. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© ARVO (1962-2015); The Authors (2016-present)
Autofluorescence imaging has become the standard for monitoring dry age related macular degeneration (AMD), particularly Geographic Atrophy.There have been few studies to understand fundus autofluorescence (FAF) changes in eyes with neovascular AMD (NVAMD). This study evaluates FAF features and atrophy in eyes with neovascular age related macular degeneration (NVAMD) in the AREDS2 study
The Age Related Eye Disease study (AREDS2) is a National Eye Institute-sponsored trial to evaluate the effect of oral supplements on progression to late AMD using color photographs at annual visits. Eyes developing NVAMD during the study period could undergo standard of care treatment. FAF images were acquired at annual visits in a subset of participants. NVAMD was considered prevalent if present in an eye prior to enrollment in the FAF substudy. Incident NVAMD was present in an eye that developed neovascularization subsequent to enrollment with at least one follow up visit. Eyes with NVAMD and FAF images were evaluated for hypoautofluorescence (classified as homogenous, heterogenous or mixed), presence of corona (a wide band of hyperautofluorescence) and reticular autofluorescence. Blocked autofluorescence due to blood was not considered hypoautofluorescence. Color photographs and FAF images were graded independently at the reading center. Presence and area of atrophy from both color photos and FAF images was measured.
After excluding eyes with poor image quality or presence of disciform scar, 1208 eyes (943 subjects) were evaluated. Hypoautofluorescence was seen in 915 (75.6%) of images with an equal distribution of homogenous and heterogenous type. Hypoautofluorescence corresponded to atrophy from color photos was graded in 567 (46.9%) of eyes with a mean area of 8.3 mm2 (+/- 7.77). Background fundus autofluorescence abnormalities were visible in 819 (68%) of eyes with reticular pattern identified in 176 (14.5%) and a corona was seen in 30% of eyes.
Fundus autofluorescence images reveal novel features in eyes with NVAMD that do and do not correspond to GA on color photos. Integrating interpretation of FAF with other modalities such as SDOCT will help understand these features further. About 50% of eyes with NVAMD undergoing treatment were associated with macular atrophy.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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