title: Classification of abnormal fundus autofluorescence patterns in the junctional zone of geographic atrophy in patients with age related macular degeneration.
abstract: OBJECTIVE
  To describe and classify patterns of abnormal fundus autofluorescence (FAF) in the junctional zone of geographic atrophy (GA) in patients with age related macular degeneration.
  
  
  METHODS
  Digital FAF images were recorded in 164 eyes of 107 patients using a confocal scanning laser ophthalmoscope (cSLO; excitation 488 nm, detection above 500 nm) as part of a prospective multicentre natural history study (FAM Study). FAF images were obtained in accordance with a standardised protocol for digital image acquisition and generation of mean images after automated alignment.
  
  
  RESULTS
  Image quality was sufficient for classification of FAF patterns in 149 eyes (90.9%) with lens opacities being the most common reason for insufficient image quality. Abnormal FAF outside GA in 149 eyes was classified into four patterns: focal (12.1%), banded (12.8%), patchy (2.0%), and diffuse (57.0%), whereby 12.1% had normal background FAF in the junctional zone. In 4% there was no predominant pattern. The diffuse pattern was subdivided into four groups including reticular (4.7%), branching (27.5%), fine granular (18.1%), and fine granular with peripheral punctate spots (6.7%).
  
  
  CONCLUSIONS
  Different phenotypic patterns of abnormal FAF in the junctional zone of GA can be identified with cSLO FAF imaging. These distinct patterns may reflect heterogeneity at a cellular and molecular level in contrast with a non-specific ageing process. A refined phenotypic classification may be helpful to identify prognostic determinants for the spread of atrophy and visual loss, for identification of genetic risk factors as well as for the design of future interventional trials.
authors.affiliation: Department of Ophthalmology, University of Bonn, Ernst-Abbe-Strasse 2, D-53127 Bonn, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Bindewald
authors.forename: S
authors.initials: S
authors.lastname: Schmitz-Valckenberg
authors.forename: J J
authors.initials: JJ
authors.lastname: Jorzik
authors.forename: J
authors.initials: J
authors.lastname: Dolar-Szczasny
authors.forename: H
authors.initials: H
authors.lastname: Sieber
authors.forename: C
authors.initials: C
authors.lastname: Keilhauer
authors.forename: A W A
authors.initials: AW
authors.lastname: Weinberger
authors.forename: S
authors.initials: S
authors.lastname: Dithmar
authors.forename: D
authors.initials: D
authors.lastname: Pauleikhoff
authors.forename: U
authors.initials: U
authors.lastname: Mansmann
authors.forename: S
authors.initials: S
authors.lastname: Wolf
authors.forename: F G
authors.initials: FG
authors.lastname: Holz
mesh_terms: D000368:Aged; D001284:Atrophy / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005584:Fovea Centralis / Q000473:pathology; D006801:Humans; D008268:Macular Degeneration / Q000473:pathology*; D008297:Male; D009887:Ophthalmoscopy / Q000379:methods; D010857:Pigment Epithelium of Eye / Q000473:pathology; D011446:Prospective Studies; D012160:Retina / Q000473:pathology; D012171:Retinal Vessels / Q000473:pathology