Progreion of Geographic Atrophy and Impact of Fundu Autofluorecence Pattern in Age-related Macular Degeneration Original Reearch Article

Purpoe To tet if fundu autofluorecence (FAF) pattern around geographic atrophy (GA) have an impact on GA progreion rate over time in atrophic age-related macular degeneration (AMD). Deign Propective longitudinal multicenter natural hitory tudy. Method tandardized digital FAF image were obtained from 195 eye of 129 patient with GA uing confocal canning laer ophthalmocopy (excitation 488 nm, emiion >500 nm). Area of GA were quantified and pattern of abnormal FAF in the junctional zone were claified. Repeated FAF image were obtained over a median follow-up period of 1.80 year (interquartile range [IQR], 1.28 to 3.34). Reult Area of GA (median, 7.04 mm2 at baeline; IQR, 3.12 to 10.0) howed a median enlargement of 1.52 mm2/year (IQR, 0.81 to 2.33). Progreion rate in eye with the banded (median 1.81 mm2/year) and the diffue FAF pattern (1.77 mm2/year) were ignificantly higher compared to eye without FAF abnormalitie (0.38 mm2/year) and focal FAF pattern (0.81 mm2/year, P < .0001). Within the group of the diffue pattern, eye with a diffue trickling pattern could be identified that exhibited an even higher pread rate (median 3.02 mm2/year) compared to the other diffue type (1.67 mm2/year, P = .001). Concluion The reult indicate that ditinct phenotypic FAF pattern have an impact on dieae progreion in eye with atrophic AMD and may therefore erve a prognotic determinant. The finding undercore the relevance of FAF imaging and the pathogenetic role of exceive retinal pigment epithelium (RPE) lipofucin (LF) accumulation in GA. Natural hitory data and identification of high-rik characteritic will be helpful to deign interventional tudie aiming at lowing the pread of atrophy.