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Charlotte Anne Melzer, Focke Ziemssen, Nicole Eter, Christian Karl Brinkmann, Hansjürgen Agostini, Gisela Haeusser-Fruh, Uwe Rose, Marc Schargus, Katrin Lorenz, Frank G Holz, Steffen Schmitz-Valckenberg; Presence and progression of atrophic areas in pathological myopia. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4352.
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© ARVO (1962-2015); The Authors (2016-present)
The multicenter, longitudinal HELP observational study prospectively investigates the natural course of pathological myopia in Caucasians. The aim of this analysis was to evaluate the development and progression of atrophy areas.
One hundred and fifty subjects (age: 57.2 (± 12.7) years) were recruited in 25 centers across Germany between 2014 and 2016. Main inclusion criteria included axial length> 26 mm, best corrected visual acuity (BCVA) ≥ 0.05 and the presence of at least one of five pre-defined morphological risk factors in the study eye approved by the independent central reading center (CRC). At baseline and annual visits, the presence and localisation of atrophy in study and non-study eye were determined by multimodal imaging including color fundus photography (three-field imaging), fundus autofluorescence (two-field imaging), and spectral domain optical coherence tomography (central 30 ° field) by the CRC. If possible, area size was quantified using RegionFinder software and the enlargement rate of atrophy over the time was determinted for up to three atrophy areas per eye, provided individual spots were completely covered within the field of view. (German Clinical Trial Register DRKS00007761).
At least one atrophic area was present in 82 eyes of 61 (40.6%) patients at baseline, of which 26 eyes presenting more than three lesions. In 58 eyes, atrophy areas were completely detected within two-field fundus autofluorescence imaging, while in the remaining 24 eyes the atrophy areas partially exceeded the edge of the image field. Mean size of single atrophic spots was 1.29 mm2 (range, 0.01-11.07 mm2) and mean total lesion size per eye was 1.90 (0.05-31.03 mm2), respectively. On average, atrophy areas increased by 0.24 mm2/year (0-1.93 mm2) in the first, by 0.2 mm2/year (0-1.33 mm2) in the second and by 0.21 mm2/year (0-1.19 mm2) in the third year.
The progression of atrophic areas in pathological myopia can be quantified by multimodal imaging. The annual enlargement rate is highly variable and markedly lower compared to the progression of geographic atrophy associated with age-related macular degeneration.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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