Abstract
Purpose: :
Retinal autofluorescence (AF) reflects the amount of lipofucsin within the retinal pigment epithelium (RPE). It increases with age and in chronic chorio–retinal diseases, thus preceding changes which lead to atrophy. AF is also an indicator of still viable RPE cells. The aim of this study was to evaluate if AF may predict the long–term visual outcome in patients with exudative age–related macular degeneration (ARMD).
Methods: :
Forty–one patients with ARMD and occult choroidal neovascularization have been studied for 488nm AF (HRA Heidelberg, Germany), retinal sensitivity and fixation stability by means of microperimetry (MP1, Nidek Co, Japan). Fluo/ICG angiography and OCT retinal thickness analysis were also done. Patients received PDT according to standard guidelines and were followed for one year.
Results: :
At baseline areas of decreased or absent AF showed markedly reduced sensitivity, while increased AF could be associated both to normal or decreased retinal sensitivity. One year after treatment, decreased/absent AF did not show sensitivity improvement. Areas which at baseline showed higher AF, recovered a near normal sensitivity if associated to inactivation of the CNV. At the end of the follow–up, visual acuity was significantly better in eyes which originally showed higher AF.
Conclusions: :
AF, reflecting the amount of vital RPE cells, provides information on the potential functional recovery of the retinal structures. In exudative ARMD, increased AF seems to be associated to better final functional outcomes despite the present of altered retinal sensitivity. AF may be considered a predictor of visual prognosis in patients with exudative ARMD that can be eligible for PDT.
Keywords: age-related macular degeneration • retinal pigment epithelium • photodynamic therapy