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Amitha Domalpally, Ronald P Danis, Emily Y Chew, Srinivas R Sadda, Traci E Clemons, Thomas R Friberg, AREDS2 -OPERA Study; Ultra Wide Field Autofluorescence Imaging in Age Related Macular Degeneration- Optos Peripheral Retina (OPERA) Age Related Eye Disease Study 2(AREDS2) Ancillary Study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3410.
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© ARVO (1962-2015); The Authors (2016-present)
To characterize abnormalities in the peripheral retina using ultrawidefield (UWF) autofluorescence (AF) images in eyes with age related macular degeneration (AMD)
UWF images (200 degrees) centered on the posterior pole as well as steered inferiorly and superiorly were acquired using Optos 200Tx devices in a subset of subjects in the AREDS2 trial (NCT: 00345176). The images were montaged after non linearity correction and overlaid with a custom grid to identify three zones. Zone 1 captured the area within the arcades including the disc and macula. Zone 2 extended up to the vortex veins and zone 3 beyond the vortex veins. Corresponding color and AF images were acquired and abnormalities in AF were correlated with features on color photos.
UWF AF images for 443 eyes were acquired of which 423 (95%) eyes could be montaged and evaluated. All eyes could be graded for lesions in zones 1 and 2. In zone 3, the inferior retina had a higher ungradable rate than the superior part (35% vs 12%). Abnormal AF was evaluated in 95% of eyes in zone 1, 85% in zone 2 and 35% in zone 3 with hypoAF in 52%, 23% and 11% and hyper AF in 10%, 3% and 1% respectively. Reticular AF was seen in 7% of eyes in zones 1 and 2 and 2 % in zone 3; of these, correspondence with reticular drusen on color photos was seen in 60%. Among abnormalities seen in zone 3, 10% of eyes had well-demarcated areas of hypoAF corresponding to cobblestone atrophy on colors and 81% of eyes had an irregular AF pattern, corresponding to reticular pigment changes on color. Lesions were similarly distributed in all quadrants of zones 2 and 3.
A large number of eyes with AMD have autofluorescence abnormalities in the midperiphery and one third in the peripheral retina. An irregular AF pattern corresponding to reticular pigmentary changes was the most common peripheral abnormality. UWF imaging with steered views allows evaluation of the peripheral retina, overcoming artifacts due to lids and lashes.
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