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J. R. Armstrong, M. Webster, A. Domalpally, R. Danis, Jr., B. Blodi, B. Zhang, M. Fleischli, H. Larry, Age-Related Eye Diseases Study 2 Research Group; Comparison of Fundus Autofluorescence Images to Digital Color Images for RPE Atrophy in AREDS2. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2234. doi: https://doi.org/.
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Autofluorescence imaging of the fundus (FAF) reveals the presence of lipofuscin in the retinal pigment epithelium (RPE). Decreased AF has been found to correlate to RPE atrophy, especially geographic atrophy (GA), the dry form of Age-Related Macular Degeneration (AMD). Our study compares decreased autofluorescence in FAF images to the presence of GA in stereoscopic color images in the eyes of AREDS2 participants.
FAF images of both eyes of 58 AREDS2 participants, taken with the Heidelberg HRA2, were assessed by two ocular disease evaluators using the AREDS2 FAF protocol. Decreased autofluorescence was defined as well circumscribed homogenous dark areas with a minimum size of drusen circle I2 (350µm). Stereo color images were obtained and evaluated for GA (also with a minimum size of circle I2) as described in AREDS Report #6 (Am J Ophthalmol, 1991).
Of the 116 eyes, 25 were excluded due to the presence of neovascular AMD or poor image quality. Of the remaining 91 eyes, 13 were found to have areas of decreased autofluorescence in FAF images 10 without definite GA in corresponding color images. In the 3 eyes with GA in color, the GA appeared within the zone of decreased autofluorescence in FAF.
FAF imaging may be able to detect RPE atrophy before development of visible signs on color images.Longitudinal evaluation of FAF images as part of AREDS2 should yield invaluable information regarding their interpretation and their potential predictive value.
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