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A New Classification of Age-related Maculopathy (ARM) with the Help of Auto-fluorescence Imaging to Facilitate the Identification of Genetic Mutations

1Keilhauer C. N., 1Schrader W., 1Haas E., 2Weber B. H. F., 1Grehn F.,
1Bayerische Julius-Maximilians-Universität Würzburg, Universitäts-Augenklinik (Würzburg)
2Julius-Maximilians-Universität Würzburg, Institut für Humangenetik, Biozentrum (Würzburg)

Purpose: Age-related maculopathy is caused by a dysfunction of the retinal pigment epithelium. It is increasingly recognized as a complex genetic disorder in that many genes might be involved. Different patterns of retinal autofluorescence visualized with a scanning laser ophthalmoscope characterize different types of age-related maculopathies. We propose, these patterns reflect different phenotypes of ARM, as dysfunction of retinal pigment epithelial cells is reflected by the visualized lipofuszin. Typically autofluorescence patterns appear similar in both eyes with ARM.
Method: Up to now 200 patients with ARM or mild forms of non-exsudative age- related macular degenerations (AMD) are analysed with a scanning laser ophthalmoscope (Heidelberg Retina Angiograph, Heidelberg Engineering, Germany: excitation 488nm, emission > 500nm). Funduscopic changes of these patients were severe pigment epithelial alterations, geographic atrophies or confluent soft drusen without leakage in angiography in at least one eye.
Results: We classified maculopathies in regard to paramacular and parapapillar autofluorescence patterns, to lipofuscin intensity and to the structure of macular lesion. So far we found 6 main groups with 3 further subgroups.
Conclusions: Topography and patterns of autofluorescence allow a characterization of ARM phenotypes to facilitate genetic analysis.

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