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E. Pilotto, P. Sportiello, E. Convento, E. Alemany-Rubio, R. Melis, S. Segalina, E. Midena; Short Wavelenght versus Near-Infrared Fundus Autofluorescence in the Diagnosis and Follow-Up of Geographic Atrophy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):263.
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To compare standard short-wavelenght fundus autofluorescence (SW-FAF) versus near infrared-wavelenght fundus autofluorescence (NIR-FAF) in detecting geographic atrophy (GA) secondary to age-related macular degeneration.
Twenty-nine consecutive patients (45 eyes) affected by GA secondary to age-related macular degeneration were studied by means of fundus autofluorescence imaging, using both SW-FAF (excitation: 488 nm) and NIR-FAF (excitation: 780 nm). All patients also underwent: 30° stereoscopic color fundus photography, spectral domain OCT and microperimetry. Microperimetry was used to assess fixation characteristics and retinal sensitivity.
In the extrafoveal region, total hypo-autofluorescent (hypo-AF) area was significantly wider with NIR-FAF versus SW-FAF (8.21 µm2 ± 6.78 and 7.62 µm2 ± 6.36 respectively; p= 0.023). On the contrary in the foveal area, total hypo-AF area was smaller with NIR-FAF versus SW-FAF (0.19 µm2 ± 0.02 and 0.42 µm2 ± 0.11 respectively; p= 0.008). When the fovea seemed massively involved by atrophy, foveal sparing was larger at NIR-FAF compared to SW-FAF (p= 0.021). In 9 cases (20%) site of fixation was located in hypo-AF area on SW- FAF, this site had normal NIR-FAF and showed persisting retinal sensitivity.
Standard SW-FAF may overestimate atrophy in the foveal area, correctly detected by NIR-FAF. In the extrafoveal area SW-FAF underestimates atrophy. Standard SW-FAF should be integrated with NIR FAF when detecting and following geographic atrophy to avoid inconsistent results and misinterpretation, from both a morphological and functional perspective.
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