Correlation between the area of increased autofluorescence surrounding geographic atrophy and disease progression in patients with AMD

Steffen Schmitz-Valckenberg, Almut Bindewald-Wittich, Joanna Dolar-Szczasny, Jens Dreyhaupt, Sebastian Wolf, Hendrik P N Scholl, Frank G. Holz

Research output: Contribution to journalArticle

Abstract

PURPOSE. To test the hypothesis that the extension of areas with increased fundus autofluorescence (FAF) outside atrophic patches correlates with the rate of spread of geographic atrophy (GA) over time in eyes with age-related macular degeneration (AMD). METHODS. The database of the multicenter longitudinal natural history Fundus Autofluorescence in AMD (FAM) Study was reviewed for patients with GA recruited through the end of August 2003, with follow-up examinations within at least 1 year. Only eyes with sufficient image quality and with diffuse patterns of increased FAF surrounding atrophy were chosen. In standardized digital FAF images (excitation, 488 nm; emission, >500 nm), total size and spread of GA was measured. The convex hull (CH) of increased FAF as the minimum polygon encompassing the entire area of increased FAF surrounding the central atrophic patches was quantified at baseline. Statistical analysis was performed with the Spearman's rank correlation coefficient (ρ). RESULTS. Thirty-nine eyes of 32 patients were included (median age, 75.0 years; interquartile range [IQR], 67.8 -78.9); median follow-up, 1.87 years; IQR, 1.43-3.37). At baseline, the median total size of atrophy was 7.04 mm 2 (IQR, 4.20 -9.88). The median size of the CH was 21.47 mm 2 (IQR, 15.19 -28.26). The median rate of GA progression was 1.72 mm2 per year (IQR, 1.10 -2.83). The area of increased FAF around the atrophy (difference between the CH and the total GA size at baseline) showed a positive correlation with GA enlargement over time (ρ = 0.60; P = 0.0002). CONCLUSIONS. FAF characteristics that are not identified by fundus photography or fluorescein angiography may serve as a prognostic determinant in advanced atrophic AMD. As the FAF signal originates from lipofuscin (LF) in postmitotic RPE cells and since increased FAF indicates excessive LF accumulation, these findings would underscore the pathophysiological role of RPE-LF in AMD pathogenesis.

Original languageEnglish (US)
Pages (from-to)2648-2654
Number of pages7
JournalInvestigative Ophthalmology and Visual Science
Volume47
Issue number6
DOIs
StatePublished - Jun 2006
Externally publishedYes

Fingerprint

Geographic Atrophy
Macular Degeneration
Disease Progression
Lipofuscin
Atrophy
Fluorescein Angiography
Photography
Nonparametric Statistics
Natural History
Databases

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Schmitz-Valckenberg, S., Bindewald-Wittich, A., Dolar-Szczasny, J., Dreyhaupt, J., Wolf, S., Scholl, H. P. N., & Holz, F. G. (2006). Correlation between the area of increased autofluorescence surrounding geographic atrophy and disease progression in patients with AMD. Investigative Ophthalmology and Visual Science, 47(6), 2648-2654. https://doi.org/10.1167/iovs.05-0892

Correlation between the area of increased autofluorescence surrounding geographic atrophy and disease progression in patients with AMD. / Schmitz-Valckenberg, Steffen; Bindewald-Wittich, Almut; Dolar-Szczasny, Joanna; Dreyhaupt, Jens; Wolf, Sebastian; Scholl, Hendrik P N; Holz, Frank G.

In: Investigative Ophthalmology and Visual Science, Vol. 47, No. 6, 06.2006, p. 2648-2654.

Research output: Contribution to journalArticle

Schmitz-Valckenberg, S, Bindewald-Wittich, A, Dolar-Szczasny, J, Dreyhaupt, J, Wolf, S, Scholl, HPN & Holz, FG 2006, 'Correlation between the area of increased autofluorescence surrounding geographic atrophy and disease progression in patients with AMD', Investigative Ophthalmology and Visual Science, vol. 47, no. 6, pp. 2648-2654. https://doi.org/10.1167/iovs.05-0892
Schmitz-Valckenberg, Steffen ; Bindewald-Wittich, Almut ; Dolar-Szczasny, Joanna ; Dreyhaupt, Jens ; Wolf, Sebastian ; Scholl, Hendrik P N ; Holz, Frank G. / Correlation between the area of increased autofluorescence surrounding geographic atrophy and disease progression in patients with AMD. In: Investigative Ophthalmology and Visual Science. 2006 ; Vol. 47, No. 6. pp. 2648-2654.
@article{7c3c132ea08841fcbbe5035645dc078b,
title = "Correlation between the area of increased autofluorescence surrounding geographic atrophy and disease progression in patients with AMD",
abstract = "PURPOSE. To test the hypothesis that the extension of areas with increased fundus autofluorescence (FAF) outside atrophic patches correlates with the rate of spread of geographic atrophy (GA) over time in eyes with age-related macular degeneration (AMD). METHODS. The database of the multicenter longitudinal natural history Fundus Autofluorescence in AMD (FAM) Study was reviewed for patients with GA recruited through the end of August 2003, with follow-up examinations within at least 1 year. Only eyes with sufficient image quality and with diffuse patterns of increased FAF surrounding atrophy were chosen. In standardized digital FAF images (excitation, 488 nm; emission, >500 nm), total size and spread of GA was measured. The convex hull (CH) of increased FAF as the minimum polygon encompassing the entire area of increased FAF surrounding the central atrophic patches was quantified at baseline. Statistical analysis was performed with the Spearman's rank correlation coefficient (ρ). RESULTS. Thirty-nine eyes of 32 patients were included (median age, 75.0 years; interquartile range [IQR], 67.8 -78.9); median follow-up, 1.87 years; IQR, 1.43-3.37). At baseline, the median total size of atrophy was 7.04 mm 2 (IQR, 4.20 -9.88). The median size of the CH was 21.47 mm 2 (IQR, 15.19 -28.26). The median rate of GA progression was 1.72 mm2 per year (IQR, 1.10 -2.83). The area of increased FAF around the atrophy (difference between the CH and the total GA size at baseline) showed a positive correlation with GA enlargement over time (ρ = 0.60; P = 0.0002). CONCLUSIONS. FAF characteristics that are not identified by fundus photography or fluorescein angiography may serve as a prognostic determinant in advanced atrophic AMD. As the FAF signal originates from lipofuscin (LF) in postmitotic RPE cells and since increased FAF indicates excessive LF accumulation, these findings would underscore the pathophysiological role of RPE-LF in AMD pathogenesis.",
author = "Steffen Schmitz-Valckenberg and Almut Bindewald-Wittich and Joanna Dolar-Szczasny and Jens Dreyhaupt and Sebastian Wolf and Scholl, {Hendrik P N} and Holz, {Frank G.}",
year = "2006",
month = "6",
doi = "10.1167/iovs.05-0892",
language = "English (US)",
volume = "47",
pages = "2648--2654",
journal = "Investigative Ophthalmology and Visual Science",
issn = "0146-0404",
publisher = "Association for Research in Vision and Ophthalmology Inc.",
number = "6",

}

TY - JOUR

T1 - Correlation between the area of increased autofluorescence surrounding geographic atrophy and disease progression in patients with AMD

AU - Schmitz-Valckenberg, Steffen

AU - Bindewald-Wittich, Almut

AU - Dolar-Szczasny, Joanna

AU - Dreyhaupt, Jens

AU - Wolf, Sebastian

AU - Scholl, Hendrik P N

AU - Holz, Frank G.

PY - 2006/6

Y1 - 2006/6

N2 - PURPOSE. To test the hypothesis that the extension of areas with increased fundus autofluorescence (FAF) outside atrophic patches correlates with the rate of spread of geographic atrophy (GA) over time in eyes with age-related macular degeneration (AMD). METHODS. The database of the multicenter longitudinal natural history Fundus Autofluorescence in AMD (FAM) Study was reviewed for patients with GA recruited through the end of August 2003, with follow-up examinations within at least 1 year. Only eyes with sufficient image quality and with diffuse patterns of increased FAF surrounding atrophy were chosen. In standardized digital FAF images (excitation, 488 nm; emission, >500 nm), total size and spread of GA was measured. The convex hull (CH) of increased FAF as the minimum polygon encompassing the entire area of increased FAF surrounding the central atrophic patches was quantified at baseline. Statistical analysis was performed with the Spearman's rank correlation coefficient (ρ). RESULTS. Thirty-nine eyes of 32 patients were included (median age, 75.0 years; interquartile range [IQR], 67.8 -78.9); median follow-up, 1.87 years; IQR, 1.43-3.37). At baseline, the median total size of atrophy was 7.04 mm 2 (IQR, 4.20 -9.88). The median size of the CH was 21.47 mm 2 (IQR, 15.19 -28.26). The median rate of GA progression was 1.72 mm2 per year (IQR, 1.10 -2.83). The area of increased FAF around the atrophy (difference between the CH and the total GA size at baseline) showed a positive correlation with GA enlargement over time (ρ = 0.60; P = 0.0002). CONCLUSIONS. FAF characteristics that are not identified by fundus photography or fluorescein angiography may serve as a prognostic determinant in advanced atrophic AMD. As the FAF signal originates from lipofuscin (LF) in postmitotic RPE cells and since increased FAF indicates excessive LF accumulation, these findings would underscore the pathophysiological role of RPE-LF in AMD pathogenesis.

AB - PURPOSE. To test the hypothesis that the extension of areas with increased fundus autofluorescence (FAF) outside atrophic patches correlates with the rate of spread of geographic atrophy (GA) over time in eyes with age-related macular degeneration (AMD). METHODS. The database of the multicenter longitudinal natural history Fundus Autofluorescence in AMD (FAM) Study was reviewed for patients with GA recruited through the end of August 2003, with follow-up examinations within at least 1 year. Only eyes with sufficient image quality and with diffuse patterns of increased FAF surrounding atrophy were chosen. In standardized digital FAF images (excitation, 488 nm; emission, >500 nm), total size and spread of GA was measured. The convex hull (CH) of increased FAF as the minimum polygon encompassing the entire area of increased FAF surrounding the central atrophic patches was quantified at baseline. Statistical analysis was performed with the Spearman's rank correlation coefficient (ρ). RESULTS. Thirty-nine eyes of 32 patients were included (median age, 75.0 years; interquartile range [IQR], 67.8 -78.9); median follow-up, 1.87 years; IQR, 1.43-3.37). At baseline, the median total size of atrophy was 7.04 mm 2 (IQR, 4.20 -9.88). The median size of the CH was 21.47 mm 2 (IQR, 15.19 -28.26). The median rate of GA progression was 1.72 mm2 per year (IQR, 1.10 -2.83). The area of increased FAF around the atrophy (difference between the CH and the total GA size at baseline) showed a positive correlation with GA enlargement over time (ρ = 0.60; P = 0.0002). CONCLUSIONS. FAF characteristics that are not identified by fundus photography or fluorescein angiography may serve as a prognostic determinant in advanced atrophic AMD. As the FAF signal originates from lipofuscin (LF) in postmitotic RPE cells and since increased FAF indicates excessive LF accumulation, these findings would underscore the pathophysiological role of RPE-LF in AMD pathogenesis.

UR - http://www.scopus.com/inward/record.url?scp=33745641375&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745641375&partnerID=8YFLogxK

U2 - 10.1167/iovs.05-0892

DO - 10.1167/iovs.05-0892

M3 - Article

C2 - 16723482

AN - SCOPUS:33745641375

VL - 47

SP - 2648

EP - 2654

JO - Investigative Ophthalmology and Visual Science

JF - Investigative Ophthalmology and Visual Science

SN - 0146-0404

IS - 6

ER -