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RS Apte, JS Sunness, NM Bressler, CA Applegate; Baseline Fluorescein Angiographic Findings In Patients With Geographic Atrophy . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2505.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate baseline fluorescein angiograms (FA) of patients with geographic atrophy (GA) in order to potentially identify characteristics predictive of GA progression, visual loss, or development of choroidal neovascularization (CNV). Methods: Baseline FA of 76 patients diagnosed with GA without CNV as defined by fundus photography and baseline fluorescein angiogram were analyzed. GA was further characterized by size, boundaries, presence or absence of choroidal vessels, and pattern of fluorescence. Pigment patterns, peripapillary (PP) changes, and characteristics of the foveal center were documented. Results: Visible choroidal vessels and more than 500 microns of uniform hyperfluorescence were present in 78%. Either some (14%) or all (80%) of the boundaries of GA were well-defined in most FA. Blocked fluorescence consistent with a pigment pattern was identified as speckled (67%), reticulated (18%), or other (49%). There was blocked fluorescence identified at the margin of GA in 49%. PP staining [greater than or equal to 180 degrees (82%) or less than 180 degrees (9%)] was documented in a large majority of FA. Less than 180 degrees of mottled hyperfluorescence without leakage was seen in 14%. The foveal center could be identified as normal in 26% and was questionable in an additional 7%. The foveal avascular zone could be well-defined in only 7% of FA. The foveal center showed definite mottled (30%), blocked (5%), or uniform (28%) hyperfluorescence pattern in cases where it was not defined as normal. Distance of the most posterior boundary of GA from the foveal center was 1-199 microns in 25%, 200-499 microns in 11%, 500-999 microns in 1%, and greater than or equal to 1000 microns in 3%, with the foveal center involved in 55%. Conclusions: Baseline FA characteristics as identified in this study will be used to identify emerging patterns predictive of progression of GA, visual loss, or development of CNV at follow-up.
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