Abstract
Abstract: :
Purpose: The study group "fundusautofluorescence in age–related maculopathy" (FAM–study) deals with the lipofuscin dependent fundus autofluorescence (AF) and its prognostic meaning in patients with age–related maculopathy (ARM) and age related macular degeneration (ARMD). In this study we examined patients with drusen in age–related maculopathy (ARM) for changes in AF. Methods: Patients with ARM were recruited for this study. Examinations included ETDRS visual acuity, funduscopy, fundus photography, and AF imaging (HRA, Heidelberg Engineering, Germany). On the basis of fundus photographs ARM eyes were categorized according to the Rotterdam Study (stage 1–3). AF patterns were divided into 8 different subtypes (minimal change, focal, patchy, speckled, reticular, lace–like, linear, focal plaque–like) according to the International Fundus Autofluorescence Classification Group. Results: In this study we included 242 eyes of 242 patients (143 women, 99 men; mean age: 71 ± 8 years). In total minimal change was found in 100 eyes, patchy pattern in 41 eyes, focal pattern in 40 eyes, speckled pattern in 18 eyes, lace–like pattern in 16 eyes, reticular pattern in 15 eyes, focal plaque–like pattern in 7 eyes, and linear pattern in 5 eyes. Eyes with minimal ARM changes (stage 1; n= 50) had predominantly minimal change pattern (82%), focal pattern was observed in 8% of eyes. Eyes with stage 2 ARM (n=73) presented in 59% minimal change, in 18% focal pattern, in 11% patchy pattern, and in 8% reticular pattern. Eyes with more advanced ARM (stage 3; n=119) showed only in 13% minimal change, in 28% patchy pattern (28%), 23 eyes with focal pattern (19%), 16 eyes with minimal change pattern (13%), 15 eyes with lace–like pattern (13%), 14 eyes with speckled pattern (12%), and 8 eyes with reticular pattern (7%). Only in eyes at stage 3 focal plaque–like pattern (6 eyes) and linear pattern (4 eyes) was found more frequently. Conclusions: The new classification system for AF in ARM allows differentiation of various phenotypes of AF changes. AF of eyes with early ARM changes showed minimal change pattern only. At ARM stage 3 all different AF–pattern were found. Most frequently was focal pattern and patchy pattern at this stage of ARM. Further studies are necessary to elucidate the role of the different AF pattern in the progression of ARM.
Keywords: age–related macular degeneration • clinical (human) or epidemiologic studies: natural history • drusen