Evaluation of Geographic Atrophy from Color Photographs and Fundus Autofluorescence Images: Age-Related Eye Disease Study 2 Report Number 11

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• 作者：Amitha Domalpally ; MD¹ ; ^{adomalpally@rc.ophth.wisc.edu" class="auth_mail" title="E-mail the corresponding author} ; Ronald Danis ; MD¹ ; Elvira Agró ; n ; MA³ ; Barbara Blodi ; MD¹ ; Traci Clemons ; PhD² ; Emily Chew ; MD³ ; the Age-Related Eye Disease Study 2 Research Group
• 关键词：AMD ; age-related macular degeneration ; AREDS2 ; Age-Related Eye Disease Study 2 ; CI ; confidence interval ; FAF ; fundus autofluorescence ; GA ; geographic atrophy ; GAP ; Geographic Atrophy Progression ; SD ; standard deviation
• 刊名：Ophthalmology
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：123
• 期：11
• 页码：2401-2407
• 全文大小：1238 K

文摘

To compare measurements of area of geographic atrophy (GA) and change in GA area from color photographs and fundus autofluorescence (FAF) images.

Design

The Age-Related Eye Disease Study 2 (AREDS2) was a prospective multicenter randomized clinical trial evaluating progression of dry age-related macular degeneration (AMD) using color photographs at annual visits over a 5-year study period. The FAF images were acquired in a subset of participants who joined the FAF ancillary study at any of the annual visits over the study period.

Participants

The AREDS2 FAF ancillary study included 8070 corresponding color and FAF visits of 2202 participants with variable follow-up.

Methods

Corresponding color and FAF images were independently evaluated at a central reading center for GA area measurement, lesion growth, and involvement of the macula center.

Main Outcome Measures

Presence, area, growth rate of GA, and involvement of center of macula from color and FAF images.

Results

Hypoautofluorescence was visible in 2048 visits (25.4%). Agreement for the presence of GA between the 2 modalities had a kappa of 0.79, with 23% of visits with hypoautofluorescence not presenting with GA on color photographs. Percentage agreement for GA presence ranged from 43% at baseline to 81% at year 5 with improving agreement over time. The mean difference in GA area between the 2 modalities was 0.5 mm², with larger areas on FAF. Growth rate of GA was 1.45 mm² from color photographs and 1.43 mm² from FAF images. The center of the macula was involved in 51% of color photographs and 56% with FAF images.

Conclusions

Geographic atrophy may be detected earlier by the use of FAF images, but over the course of the study, the 2 modalities become comparable. Progression of GA area is comparable between color photographs and FAF images, but evaluating involvement of the center of the macula may differ, probably because of macular pigmentation blocking autofluorescence.