von Rückmann A., Fitzke F., Bird A.

Institute of Ophthalmology and Moorfields Eye Hospital, London, U.K

The deviation from normal of fundus autofluorescence derived from lipofuscin in the retinal pigment epithelium has been documented in patients with age related macular degeneration (AMD)[1]. The purpose of this study was to document the changes in time of fundus autofluorescence.
Methods: Between 1993 and 2001 serial examinations of the distribution of fundus autofluorescence were performed in 112 eyes of 61 patients (age: 59-91 yrs) with all forms of AMD using a prototype confocal laser scanning ophthalmoscope (cLSO; Zeiss, Oberkochen; excitation 488 nm, barrier filter = 521 nm).
Results: Focal areas of increased autofluorescence adjacent to drusen precluded geographic atrophy. In eyes with geographic atrophy a rim of increased autofluorescence was often noted. The atrophy expanded towards the area of increased autofluorescence. Areas of focal increased autofluorescence in eyes with choroidal neovascularisation, pigment epithelial detachment and disciform scars showed a reduction in autofluorescence intensity over time.
Conclusions: Focal increased autofluorescence in eyes with drusen are an indicator for the occurence of geographic atrophy. Reduction of autofluorescence intensity in eyes with choroidal neovascularisation, pigment epithelial detachment and disciform scars indicates progression of disease and occurs due to photoreceptor and RPE cell loss. [1] A von Rückmann, FW Fitzke, AC Bird. Fundus autofluorescence in age related macular degeneration imaged with a scanning laser ophthalmoscope. Invest Ophthalmol Vis Sci 1997;38: 478-86
Supported by DFG (Ru 575/2-1) and Medical Research Council, UK

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