Abstract
Abstract: :
Purpose: The aim of fundus autofluorescence in age–related macular degeneration study group (FAM–study group) is to identify fundus autofluorescence (AF) changes as predictive factors for the progression of age related macular degeneration (AMD). Using the new classification system for AF patterns of drusen (International Fundus Autofluorescence Classification Group) we focused on changes of AF in patients with multiple soft drusen in correlation to visual function. Methods:From the outpatient department of the Eye Clinic Leipzig patients with soft drusen were recruited. Other inclusion criteria were age > 50 years, visual acuity of 20/100 or better. All patients underwent a detailed ophthalmological examination including ETDRS visual acuity, binocular funduscopy, and color fundus photography. AF imaging was performed with a confocal scanning laser ophthalmoscope (HRA, Heidelberg Engineering, Germany) following a standard protocol. The AF patterns were divided into 8 different subtypes. Their follow–up changes were correlated to visual acuity. Results: One hundred forty five patients aged from 55–86 years (mean 70 ± 7 years) were included in this prospective study. Follow–up ranged between 12 and 36 months (mean 18 ± 6 months). At baseline AF pattern showed focal areas of increased AF in 26 eyes, focal–plaque like pattern in 5 eyes, reticular pattern in 25 eyes, linear pattern in 8 eyes, lace like pattern in 11 eyes, speckled pattern in 10 eyes, 40 eyes presented patchy pattern and 20 eyes nearly normal pattern. During follow–up out of 40 eyes with patchy AF pattern 8 eyes developed exudative changes, as well as 2 eyes with focal–plaque like AF pattern and 2 eye with reticular pattern at baseline. Geographic atrophy was seen in 2 eyes with focal AF pattern and 1 eye with focal–plaque like pattern at baseline. A total of 14 eyes presented with severe visual loss (>= 6 ETDRS lines). 12 of these had patchy AF pattern. Eyes with nearly normal, linear, lace like or reticular AF pattern showed no visual deterioration during follow–up. Conclusions: Imaging of fundus autofluorescence in patients with age–related maculopathy can identify different pattern of fundus AF. Focal areas of increased AF indicate a relatively high risk of progression to ARMD with visual loss. To confirm our outcomes further studies should be performed.
Keywords: age–related macular degeneration • clinical (human) or epidemiologic studies: outcomes/complications • drusen