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Fundus autofluorescence and microperimetry in progressing geographic atrophy secondary to age-related macular degeneration
  1. Elisabetta Pilotto1,
  2. Francesca Guidolin1,
  3. Enrica Convento1,
  4. Luigi Spedicato1,
  5. Stela Vujosevic2,
  6. Fabiano Cavarzeran1,
  7. Edoardo Midena1,2
  1. 1Department of Ophthalmology, University of Padova, Padova, Italy
  2. 2G.B. Bietti Foundation, IRCCS, Roma, Italy
  1. Correspondence to Dr Edoardo Midena, Department of Ophthalmology, University of Padova, via Giustiniani 2, Padova 35128, Italy; edoardo.midena{at}unipd.it

Abstract

Purpose To prospectively analyse microperimetry, standard short-wavelength fundus autofluorescent (SW-FAF) and near infrared-wavelength FAF (NIR-FAF) changes in eyes with geographic atrophy (GA) secondary to age-related macular degeneration.

Methods Twenty consecutive eyes (14 patients) affected by GA were enrolled. Repeated microperimetric examinations and FAF images were obtained over a mean follow-up period of 12.3±4.5 months.

Results GA area was always wider on NIR-FAF versus SW-FAF images (5.05±2.40 mm2 vs 4.45±2.41 mm2, p=0.005 baseline; 5.78±2.87 mm2 vs 5.21±2.77 mm2, p<0.0001 follow-up). Mean retinal sensitivity significantly decreased during follow-up from 7.68±3.92 dB to 6.71±4.37 dB (p=0.0013). 47.3% of the relative dense scotomas (≤5 dB) progressed to dense scotoma (0 dB). Retinal areas showing relative dense scotoma and characterised by hypo-SW-FAF or hyper-NIR-FAF at baseline had a higher risk of evolving to dense scotoma compared with normo-FAF and hyper-FAF on SW-FAF (OR=2.62 and 2.77, respectively), or normo-FAF at NIR-FAF (OR=2.96).

Conclusions SW-FAF, compared with NIR-FAF, underestimates GA area at baseline and at follow-up. The enlargement rate of progression based on NIR-FAF is not greater than on SW-FAF. Different SW-FAF and NIR-FAF patterns show different relative risk of progression from relative to dense scotoma. Microperimetry, SW-FAF and NIR-FAF should be combined to obtain adequate morphological and functional prospective information.

  • Macula
  • Diagnostic tests/Investigation
  • Imaging
  • Vision

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