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Fundus Auto-fluorescence in Patients with Age-related Maculopathy: A Prospective Study

1Einbock W., 1Schnurrbusch U. E. K., 2Jorzik J., 1Wiedemann P., 2Holz F. G., 3Wolf S.,
1Universität Leipzig, Klinik und Poliklinik für Augenheilkunde (Leipzig)
2Ruprecht-Karls-Universität Heidelberg, Universitäts-Augenklinik (Heidelberg)
3Klinik und Poliklinik für Augenheilkunde, Universität Leipzig (Leipzig)

Purpose: The fundus autofluorescence in age-related macular degeneration study group (FAM-Study group) aims to identify autofluorescence (AF) changes as predictive factors for the progression of AMD. As part of this study group we focused on fundus autofluorescence in patients with age-related maculopathy (ARM) to describe AF pattern and their change over time.
Methods: Sixty patients (35 woman, 25 man) aged from 55-86 years (mean 72 ± 6 years) were included in this prospective study. Inclusion criteria were the presence of large soft drusen, visual acuity of 20/100 or better, and no previous laser treatment in the study eye. The fellow eyes presented soft drusen in 33 patients and exudative age related macular degeneration (AMD) in 12 patients. Follow-up ranged between 6 and 25 months (mean 12 ± 6 years). All patients underwent a detailed ophthalmological examination including ETDRS visual acuity, binocular funduscopy, and color fundus photography. Autofluorescence imaging was performed with a confocal scanning laser ophthalmoscope (HRA, Heidelberg Engineering, Germany). Autofluorescence images were analyzed for focal areas of increased or decreased fundus autofluorescence. Additionally, changes in fundus appearance were correlated to the autofluorescence pattern at baseline.
Results: At baseline autofluorescence images showed focal areas of disturbed autofluorescence in 50 eyes. The autofluorescence pattern showed central spots of increased AF in 28 eyes, annular pattern was noted in 12 eyes, confluent patches of increased AF were present in 8 eyes, and 2 eyes presented diffuse increased AF. During follow up 2 eyes developed areas of geographic atrophy. These areas corresponded to areas of central spots of increased AF at baseline. Two additional eyes developed exudative disease. These eyes showed confluent patches of AF at baseline.
Conclusions: Imaging of fundus autofluorescence in patients with age- related maculopathy allows to identify different pattern of fundus AF. Our preliminary data suggest that central spots of increased AF may be a risk factor for the development of geographic atrophy.

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