Changes in Fundus Autofluorescence in Patients with Age-related Maculopathy Correlation to Visual Function

Abstract

Abstract: : Purpose: The fundus autofluorescence in age-related macular degeneration study group (FAM-Study group) aims to identify autofluorescence (AF) changes as predictive factors for the progression of AMD. We report changes of fundus autofluorescence in patients with multiple soft drusen in correlation to visual function. Methods: Patient with age-related maculopathy were recruited from the outpatient department. Inclusion criteria age > 50 years, the presence of large soft drusen, visual acuity of 20/100 or better, and no previous laser treatment in the study eye. All patients underwent a detailed ophthalmological examination including ETDRS visual acuity, binocular funduscopy, and color fundus photography. Autofluorescence imaging was performed with a confocal scanning laser ophthalmoscope (HRA, Heidelberg Engineering, Germany) following a standard protocol. Autofluorescence images were analyzed for focal areas of increased or decreased fundus autofluorescence. Additionally, changes in fundus autofluorescence were correlated to visual acuity. Results: One hundred twenty patients (75 woman, 55 man) aged from 55-86 years (mean 72 ± 6 years) were included in this prospective study. The fellow eyes presented soft drusen in 51 patients and exudative age related macular degeneration (AMD) in 69 patients. Follow-up ranged between 12 and 36 months (mean 18 ± 6 months). At baseline the autofluorescence pattern showed focal areas of increased AF in 75 eyes, reticular pattern in 22 eyes, combination of focal increase and reticular pattern in 15, and 8 eyes presented diffuse increased AF. At the end of follow-up 5 eyes developed geographic atrophy, and 4 eyes developed exudative changes with severe visual loss (>= 6 ETDRS lines). All of these eyes had focal areas of increased AF at baseline. Eyes with reticular pattern or diffuse increased AF showed only minor changes during follow-up. Conclusions: Imaging of fundus autofluorescence in patients with age-related maculopathy allows to identify different pattern of fundus AF. Our preliminary data suggest that focal areas of increased AF indicate a relatively high risk of progression to ARMD with visual loss.

Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: nat • drusen