Abstract
Purpose :
To assess short- and long-term clinical changes associated with drusen regression in eyes with intermediate age-related macular degeneration (AMD).
Methods :
Sixty participants aged 50 years and older with AMD in the Age-Related Eye Disease Study 2 (AREDS2) were evaluated for one or more areas of drusen regression > circle C1 in area from baseline to year 2. These eyes had been imaged with color fundus photography (CFP) and with modified fundus camera-based (mFC) in fundus autofluorescence (FAF) imaging at baseline, year two, and year five. Areas of drusen regression were graded on color fundus photographs, using AREDS grading protocol, and FAF images.
Results :
Forty-five eyes in 60 participants demonstrated drusen regression meeting criteria from baseline to year 2. One eye progressed to neovascular AMD and was excluded from analysis. In the remaining 44 eyes, areas of drusen regression on CFP at year 2 demonstrated no clinical abnormalities in 26/44 eyes (59%), developed new pigmentary changes in 15/44 eyes (34%), and developed new areas of atrophy in 3/44 eyes (7%). Drusen regression areas at year 2 were however associated with more prevalent local changes in FAF in 31/44 eyes (70%) (56% demonstrating decreased FAF, and 14% demonstrating increased FAF). At year 5, areas of drusen regression on CFP demonstrated clinical changes in 30/44 eyes (68%) with15/44 eyes (34%) demonstrating new pigmentary changes and 15/44 eyes (34%) demonstrating new atrophy from baseline. Drusen regression areas at year 5 were associated with local changes in FAF in 38/44 eyes (86%) (70% demonstrating increased FAF, and 16% demonstrating decreased FAF).
Conclusions :
Drusen regression in intermediate AMD in the early phase (2 years) is associated with local changes in FAF patterns with relatively less prevalent changes in local clinical appearance. In the later phase (5 years), these areas progress to more pronounced changes in FAF and clinical appearance that reflect RPE disorganization and atrophy. These short and longer-term observations associate drusen regression with progressive stages of RPE change and degeneration in the context of intermediate AMD
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.