title: Geographic Atrophy and Foveal-Sparing Changes Related to Visual Acuity in Patients With Dry Age-Related Macular Degeneration Over Time.
abstract: OBJECTIVE
  To correlate the area of geographic atrophy (GA) and residual foveal sparing (FS), and to identify the minimum FS and maximum GA area allowing sufficient visual acuity (VA) for daily tasks.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Thirty-six eyes of 25 patients with GA and FS were followed for 18 months using spectral-domain optical coherence tomography and VA tests. Volume scans were imported into software enabling grading of areas in B-scans and computing of planimetric measurements in complete volume scans. Correlation of areas 1 (complete atrophy), 2 (FS in the central millimeter), and 3 (FS in the central 3 mm) with each other and with best-corrected VA (BCVA) were evaluated.
  
  
  RESULTS
  Baseline means of areas 1, 2, and 3 were 6.15 mm2, 0.49 mm2, and 3.08 mm2, respectively. At 1 year, area 1 increased by a mean of 1.33 mm2, while areas 2 and 3 were decreased by 0.12 mm2and 0.65 mm2, respectively. From baseline to 18 months and from visit to visit, all areas and BCVA changed progressively (P < .001). Significant thresholds in GA size and FS for achieving a BCVA ≥ 70 ETDRS letters were detected (area 1: ≤6 mm2; area 2: ≥0.48 mm2; and area 3: ≥3.28 mm2).
  
  
  CONCLUSIONS
  GA and FS changed inversely over time. In general, FS highly correlated with BCVA, while GA progression correlated with the central 3-mm FS regression, but not with BCVA. A threshold in GA and FS area could be determined for BCVA necessary for daily activity.
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors.forename: Ramzi Gilbert
authors.initials: RG
authors.lastname: Sayegh
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sacu
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors.forename: Roman
authors.initials: R
authors.lastname: Dunavölgyi
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors.forename: Maria Elisabeth
authors.initials: ME
authors.lastname: Kroh
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors.forename: Philipp
authors.initials: P
authors.lastname: Roberts
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Mitsch
authors.affiliation: Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors.forename: Alessio
authors.initials: A
authors.lastname: Montuoro
authors.affiliation: Department of Health Process Management, University of Applied Science Upper Austria, Steyr, Austria.
authors.forename: Margit
authors.initials: M
authors.lastname: Ehrenmüller
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. Electronic address: ursula.schmidt-erfurth@meduniwien.ac.at.
authors.forename: Ursula
authors.initials: U
authors.lastname: Schmidt-Erfurth
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000473:pathology*; D005654:Fundus Oculi; D057092:Geographic Atrophy / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008268:Macular Degeneration / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity