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Impressum
Analysis of digital SLO-fundus autofluorescence images of geographic atrophy (GA) in AMD (FAM-Study).
1Schmitz-Valckenberg S., 1Jorzik J., 2Roider J., 3Weinberger A., 4Wolf S., 1Holz F. G. für die 1FAM-Studiengruppe
Departments of Ophthalmology, University of Heidelberg, INF 400, 69120 1Heidelberg, 2Regensburg, 3Aachen, 4Leipzig
Objective: Variations of fundus autofluorescence (AF) over time
in the junctional zone of GA are recorded in the prospective fundus autofluorescence
in age-related macula degeneration (FAM)-Study. Here, we evaluate a novel
method for automated image analysis.
Methods: Until now, over 150 patients with GA due to ARMD have
been included in the FAM-Study. AF images in vivo are recorded
with a confocal SLO (exc. 488 nm, em. >500 nm; Heidelberg Retina Angiograph).
The intensity of AF in atrophic areas is typically decreased. Two independent
readers analysed these areas in 24 right eyes manually by outlining such
areas using a mouse-driven arrow (A) and automatically by image analysis
software (Global Lab Image/2) after subjective adjustement of thresholding
(B). In the following, the Bland-Altman-test was performed.
Results: Larger areas were measured using A compared to B by both
readers (agreement A/B: reader 1 1.04, 95%CI [0.66,1.42]; reader 2 0.62,
95%CI [0.43,0.81]). The agreement between the readers (intra-observer
variability) was 0.39 (95%CI [0.02,0.76]) for A and -0.03 (95%CI [- 0.23;0.18])
for B. Features making the delineation of borders of GA difficult included
large choroidal vessels with autofluorescent properties in the GA area
and media opacities.
Conclusion: Fundus AF cSLO imaging provides a reliable means to
delineate areas of GA. The automated image analysis allows more accurate
detection and quantitation documentation of atrophic areas than the manually
outlining. This method will be useful in longitudinal natural history
studies and for monitoring effects of future therapeutic interventions
to slow down progression in AMD-patients with GA. Support: DFG Ho 1926/2-1,
DFG Priority Pogram AMD (SPP 1088), State of Baden-Wuerttemberg Research
fund 500/2000