Abstract
Abstract: :
Purpose: To assess the changes in autofluorescence (AF) pattern in fellow eyes of patients with occult choroidal neovascularization over a period of three years. Methods: In the "natural history study of occult CNV" study we included 60 patients with occult CNV secondary to ARMD. Examinations in both, study and fellow eyes included ETDRS visual acuity, binocular ophthalmoscopy, AF imaging, fluorescein and ICG angiography, and colour fundus photography. AF imaging was performed with a confocal scanning laser ophthalmoscope (HRA, Heidelberg Engineering, Germany) following a standard protocol. For the description of the AF distribution eight different pattern of retinal AF were defined. These included a minimal change, nearly normal pattern, focal increased pattern, focal plaque–like pattern, patchy pattern, linear pattern, lace–like pattern, reticular pattern, and speckled pattern. We included in this analysis all fellow eye with no exudative changes at baseline and analysed the follow–up changes. Results: Forty–two fellow eyes were included in this analysis. Visual acuity ranged from 20/80 to 20/20 at baseline. At baseline AF pattern showed focal areas of increased AF in 6 eyes, focal–plaque like pattern in 2 eyes, reticular pattern in 14 eyes, linear pattern in 1 eyes, lace like pattern in 4 eyes, speckled pattern in 1 eyes, 3 eyes presented patchy pattern and 4 eyes nearly normal pattern. An initial geographic atrophy was observed in 7 eyes. During follow–up 0 eyes developed exudative changes in the fellow eyes. Geographic atrophy developed in 3 eyes with 2 reticular AF pattern and 1 eye with patchy pattern at baseline. Conclusions: Imaging of fundus AF in patients with ARMD can identify different pattern of fundus AF. This prospective study shows that reticular pattern in fellow eyes of patients with occult CNV is the most frequent finding. Additionally, reticular and patchy pattern indicate a high risk of progression to a geographic atrophy in fellow eyes.
Keywords: age-related macular degeneration • imaging/image analysis: clinical • clinical (human) or epidemiologic studies: natural history