title: Prognostic implications of imaging in atrophic macular degeneration and its use in clinical practice and clinical trial design.
abstract: Clinical prognostic markers in atrophic age-related macular degeneration include the extent of existing atrophy, fundus autofluorescence (FAF) patterns and optical coherence tomography changes in the outer retina/retinal pigment epithelium interface. The prognostic implications of these findings may be used to determine not just the rate of disease progression but also influence the likelihood, magnitude and clinical relevance of therapy responses. FAF phenotypes have been extensively investigated; however, the pathophysiological mechanisms behind their appearance have not been fully elucidated. Optical coherence tomography imaging is additive to FAF imaging in atrophic age-related macular degeneration, allowing the visualization of detail not available through FAF imaging whilst also displaying subtle changes correlating with the FAF phenotypes themselves, thereby giving clues to their histological determinates. The developing understanding of these imaging modalities and consequent development of prognostically useful classification systems have widespread implication in clinical care and clinical trial design.
authors.affiliation: School of Medicine, University of Queensland Mayne Medical School, Herston, Queensland, Australia.
authors.forename: Paul Cc
authors.initials: PC
authors.lastname: Lim
authors.affiliation: School of Medicine, University of Queensland Mayne Medical School, Herston, Queensland, Australia.|Gallipoli Medical Research Institute, Newdegate St, Greenslopes Australia, Greenslopes Private Hospital, Greenslopes, Queensland, Australia.|Ophthalmology Department, Greenslopes Private Hospital, Brisbane, Queensland, Australia.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Layton
mesh_terms: D002986:Clinical Trials as Topic; D005451:Fluorescein Angiography; D057092:Geographic Atrophy / Q000000981:diagnostic imaging*; D006801:Humans; D008268:Macular Degeneration / Q000000981:diagnostic imaging*; D061848:Optical Imaging; D011379:Prognosis; D012107:Research Design; D055213:Retinal Pigment Epithelium / Q000000981:diagnostic imaging*; D041623:Tomography, Optical Coherence
keywords: atrophic age-related macular degeneration; clinical trials; fundus autofluorescence; optical coherence tomography; phenotypes