May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Fundus Autofluorescence Patterns in the Junctional Zone as Prognostic Determinants for Spread of Geographic Atrophy in Age–related Macular Degeneration (AMD)
A. Bindewald; J. Dolar–Szczasny; H. Sieber; S. Schmitz–Valckenberg; J.J. Jorzik; C. Keilhauer; D. Pauleikhoff; S. Wolf; U. Mansmann; F.G. Holz
Author Affiliations & Notes
  • A. Bindewald
    Department of Ophthalmology, University of Bonn, Bonn, Germany
  • J. Dolar–Szczasny
    First Eye Hospital, Medical University of Lublin, Lublin, Poland
  • H. Sieber
    Department of Ophthalmology,
    University of Heidelberg, Heidelberg, Germany
  • S. Schmitz–Valckenberg
    Department of Ophthalmology,
    University of Heidelberg, Heidelberg, Germany
  • J.J. Jorzik
    Department of Ophthalmology,
    University of Heidelberg, Heidelberg, Germany
  • C. Keilhauer
    Department of Ophthalmology, University of Wuerzburg, Wuerzburg, Germany
  • D. Pauleikhoff
    Department of Ophthalmology, University of Muenster, Muenster, Germany
  • S. Wolf
    Department of Ophthalmology, University of Leipzig, Leipzig, Germany
  • U. Mansmann
    Institute for Medical Biometry,
    University of Heidelberg, Heidelberg, Germany
  • F.G. Holz
    Department of Ophthalmology, University of Bonn, Bonn, Germany
  • Footnotes
    Commercial Relationships  A. Bindewald, None; J. Dolar–Szczasny, None; H. Sieber, None; S. Schmitz–Valckenberg, None; J.J. Jorzik, None; C. Keilhauer, None; D. Pauleikhoff, None; S. Wolf, None; U. Mansmann, None; F.G. Holz, None.
  • Footnotes
    Support  DFG grants: AMD Research Priority program SPP 1088, Ho 1926/1–2, Ho 1926/2–2, MA 1723/1–1, Wo 478/10
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 2960. doi:
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      A. Bindewald, J. Dolar–Szczasny, H. Sieber, S. Schmitz–Valckenberg, J.J. Jorzik, C. Keilhauer, D. Pauleikhoff, S. Wolf, U. Mansmann, F.G. Holz; Fundus Autofluorescence Patterns in the Junctional Zone as Prognostic Determinants for Spread of Geographic Atrophy in Age–related Macular Degeneration (AMD) . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2960.

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Abstract

Abstract: : Purpose: To test the hypothesis that different phenotypic patterns of abnormal fundus autofluorescence (FAF) in the junctional zone of geographic atrophy (GA) due to AMD have an impact on disease progression. Methods: In the prospective, multicenter natural history FAM (Fundus Autofluorescence in AMD) Study FAF images were recorded with a confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph, exc. 488 nm, em. > 500 nm) according to a standardized protocol. Areas of GA were quantified on digital images. Visual acuity (ETDRS) was determined and blood samples were taken for further genetic analyses. Standardized CRF’s were applied to document potential risk factors. In 225 eyes of 147 patients examinations were repeated in 6.7 months intervals (interquartile range, IQR 13.0–5.2) with a review period of 21.1 months (IQR 37.4–13.6). Results: Phenotypic patterns of abnormal FAF in the junctional zone of GA were classified into focal, banded, patchy and diffuse pattern, or normal FAF signal. Enlargement of atrophic areas ranged from 0.006 to 11.88 mm2/year (mean: 1.92 ± 1.89). Eyes with diffuse FAF changes outside the GA showed a significantly higher rate of spread (mean 2.05 ± 1.93 mm2/year) compared to eyes with no or minimal, i.e. focal and banded, FAF changes (mean 1.29 ± 1.02 mm2/year; p = 0.025). No significant relationship was found between disease progression and body mass index, smoking, hypertension or diabetes. Conclusions: The results indicate that refined phenotyping based on FAF imaging in advanced atrophic AMD allows for identification of novel risk factors for disease progression. This implicates a pathogenetic role of excessive lipofuscin accumulation in RPE cells with regard to development of GA since the AF signal derives from RPE lipofuscin. These data will be helpful for the design of future interventional trials in patients with atrophic AMD. Since various FAF patterns are assumed to reflect heterogeneity on a molecular level phenotyping with FAF may be useful to identify genetic risk factors.

Keywords: age–related macular degeneration • clinical (human) or epidemiologic studies: natural history • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) 
© 2004, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2024 Association for Research in Vision and Ophthalmology.
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