December 2002
Volume 43, Issue 13
Free
ARVO Annual Meeting Abstract  |   December 2002
Patterns of Abnormal Autofluorescence in Advanced Atrophic ARMD: Classification and Implications for Progression
S Schmitz-Valckenberg; JJ Jorzik; W Einbock; S Witte; F Schutt; S Dithmar; S Wolf; FG HolzFAM-Study Group
Author Affiliations & Notes
  • S Schmitz-Valckenberg
    Department of Ophthalmology
    University of Heidelberg Heidelberg Germany
  • JJ Jorzik
    Department of Ophthalmology
    University of Heidelberg Heidelberg Germany
  • W Einbock
    Department of Ophthalmology University of Leipzig Leipzig Germany
  • S Witte
    Department of Biometry
    University of Heidelberg Heidelberg Germany
  • F Schutt
    Department of Ophthalmology
    University of Heidelberg Heidelberg Germany
  • S Dithmar
    Department of Ophthalmology
    University of Heidelberg Heidelberg Germany
  • S Wolf
    Department of Ophthalmology University of Leipzig Leipzig Germany
  • FG HolzFAM-Study Group
    Department of Ophthalmology
    University of Heidelberg Heidelberg Germany
  • Footnotes
    Commercial Relationships   S. Schmitz-Valckenberg, None; J.J. Jorzik, None; W. Einbock, None; S. Witte, None; F. Schutt, None; S. Dithmar, None; S. Wolf, None; F.G. Holz, None. Grant Identification: Supported by DFG Ho 1926/2-1, Research Priority Program AMD (SPP1088) of the DFG
Investigative Ophthalmology & Visual Science December 2002, Vol.43, 2518. doi:
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      S Schmitz-Valckenberg, JJ Jorzik, W Einbock, S Witte, F Schutt, S Dithmar, S Wolf, FG HolzFAM-Study Group; Patterns of Abnormal Autofluorescence in Advanced Atrophic ARMD: Classification and Implications for Progression . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2518.

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Abstract

Abstract: : Purpose:To introduce a new classification for abnormal autofluorescence (AF) patterns in the junctional zone of geographic atrophy (GA) associated with ARMD and to correlate rates of spread of the atrophic areas. Methods:Digital autofluorescence (AF) images were recorded in 406 eyes from 239 patients with GA using a confocal SLO (exc. 488 nm, em. above 500 nm; Heidelberg Retina Angiograph) as part of the prospective, multicenter FAM-Study (Fundus Autofluorescence in Age-related Macular Degeneration). Baseline images were assessed for abnormal patterns of AF in the junctional zone. Serial images of 44 eyes over 1 to 4,5 years were analyzed for spread of atrophy using an automated computerized image analysis method for delineation and quantitation of GA. Results:Image quality was sufficient in 210 eyes (52%) to allow a meaningful analysis. Distinct patterns of abnormal AF were classified into focal (7%), band (20%), diffuse (63%), and patchy homogeneous (1%) while some eyes showed no elevated AF (9%). The diffuse pattern was subclassified into reticular (7%), fine granular (30%), branching (53%) and fine granular with punctate peripheral spots (10%). Mean relative progression rates per year differed between types of abnormal AF-patterns ranging from 15,2% (focal) to 424% (patchy homogeneous). Conclusion:Distinct phenotypic pattern of abnormal AF in the junctional zone of GA can be determined using cSLO-AF-imaging. The results indicate that these have an impact on progression rates of atrophy over time and, thus, of visual loss. Since RPE-lipofuscin contains the dominant fluorophores responsible for fundus AF detected with the cSLO-method applied herein, the observations implicate that excessive lipofuscin accumulation plays an important role in the pathogenesis of RPE-cell death in GA due to ARMD. We speculate that different AF-patterns reflect heterogeneity at the cellular and molecular level. Clinical AF-recording allows identification of novel prognostic determinants and may be helpful in monitoring future therapeutic interventions to slow down progression of GA.

Keywords: 308 age-related macular degeneration • 567 retinal pigment epithelium • 352 clinical (human) or epidemiologic studies: natural history 
© 2002, 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 © 2025 Association for Research in Vision and Ophthalmology.
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