title: Drusen regression is associated with local changes in fundus autofluorescence in intermediate age-related macular degeneration.
abstract: OBJECTIVE
  To investigate the association of spontaneous drusen regression in intermediate age-related macular degeneration (AMD) with changes on fundus photography and fundus autofluorescence (FAF) imaging.
  
  
  METHODS
  Prospective observational case series.
  
  
  METHODS
  Fundus images from 58 eyes (in 58 patients) with intermediate AMD and large drusen were assessed over 2 years for areas of drusen regression that exceeded the area of circle C1 (diameter 125 μm; Age-Related Eye Disease Study grading protocol). Manual segmentation and computer-based image analysis were used to detect and delineate areas of drusen regression. Delineated regions were graded as to their appearance on fundus photographs and FAF images, and changes in FAF signal were graded manually and quantitated using automated image analysis.
  
  
  RESULTS
  Drusen regression was detected in approximately half of study eyes using manual (48%) and computer-assisted (50%) techniques. At year-2, the clinical appearance of areas of drusen regression on fundus photography was mostly unremarkable, with a majority of eyes (71%) demonstrating no detectable clinical abnormalities, and the remainder (29%) showing minor pigmentary changes. However, drusen regression areas were associated with local changes in FAF that were significantly more prominent than changes on fundus photography. A majority of eyes (64%-66%) demonstrated a predominant decrease in overall FAF signal, while 14%-21% of eyes demonstrated a predominant increase in overall FAF signal.
  
  
  CONCLUSIONS
  FAF imaging demonstrated that drusen regression in intermediate AMD was often accompanied by changes in local autofluorescence signal. Drusen regression may be associated with concurrent structural and physiologic changes in the outer retina.
authors.affiliation: Unit on Neuron-Glia Interactions in Retinal Disease, National Eye Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Toy
authors.affiliation: Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Nupura
authors.initials: N
authors.lastname: Krishnadev
authors.affiliation: Unit on Neuron-Glia Interactions in Retinal Disease, National Eye Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Maanasa
authors.initials: M
authors.lastname: Indaram
authors.affiliation: Office of the Clinical Director, National Eye Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Denise
authors.initials: D
authors.lastname: Cunningham
authors.affiliation: Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Cukras
authors.affiliation: Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Emily Y
authors.initials: EY
authors.lastname: Chew
authors.affiliation: Unit on Neuron-Glia Interactions in Retinal Disease, National Eye Institute, National Institutes of Health, Bethesda, Maryland. Electronic address: wongw@nei.nih.gov.
authors.forename: Wai T
authors.initials: WT
authors.lastname: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008268:Macular Degeneration / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010781:Photography; D015995:Prevalence; D011446:Prospective Studies; D012075:Remission, Spontaneous; D015593:Retinal Drusen / Q000175:diagnosis* / Q000503:physiopathology