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Frank G. Holz, Caren Bellman, Stephanie Staudt, Florian Schütt, Hans E. Völcker; Fundus Autofluorescence and Development of Geographic Atrophy in Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2001;42(5):1051-1056.
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purpose. To describe the development of new and enlargement of preexisting
atrophy confined to areas with abnormally high levels of in vivo
autofluorescence in eyes with geographic atrophy (GA) associated with
age-related macular degeneration (ARMD).
methods. The spatial distribution and intensity of fundus autofluorescence as
well as the spread of GA and occurrence of new GA was recorded over a
period of 3 years in three patients with ARMD using a confocal scanning
results. A diffuse irregular increased autofluorescence at the posterior pole
was recorded at baseline in the presence of unifocal or multifocal
patches of geographic atrophy. Within these areas of elevated
autofluorescence, new atrophic areas developed, and existing patches of
atrophy enlarged during the review period, whereas this was not
observed in areas with normal background autofluorescence. The total
area of abnormal autofluorescence also showed enlargement over time.
conclusions. These preliminary findings suggest that areas of increased
autofluorescence precede the development and enlargement of outer
retinal atrophy in eyes with ARMD. Because the dominant fluorophores of
fundus autofluorescence are part of lipofuscin granules of RPE cells,
the observations indicate that excessive RPE lipofuscin accumulation
may be of significance in the pathogenesis of GA associated with ARMD.
With GA being a major cause for severe visual loss in ARMD, in vivo
fundus autofluorescence recording over time may allow identification of
prognostic determinants and may give important clues to the
understanding of mechanisms of disease.
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