Author: Kato, Aki ; Nishiyama, Takeshi ; Hirano, Yoshio ; Ishibashi, Tatsuro ; Saito, Masaaki ; Sekiryu, Tetsuju ; Nakamura, Mayumi ; Matsuno, Kiyoshi ; Shinojima, Ari ; Hara, Chikako ; Kuno, Noriyuki ; Yasukawa, Tsutomu ; Iida, Tomohiro ; Gomi, Fumi ; Yuzawa, Mitsuko ; Sawa, Miki ; Mori, Ryusaburo ; Kimura, Erika ; Asato, Hitomi ; Oshima, Yuji ; Ashikari, Masayuki ; Sugano, Yukinori ; Ogura, Yuichiro

PURPOSEAbnormal fundus autofluorescence (FAF) potentially precedes onset of late age-related macular degeneration (AMD) in Caucasian patients. Many differences exist between Asian and Caucasian patients regarding AMD types and severity, gender, and genetic backgrounds. We investigated the characteristics of abnormal FAF and retinal sensitivity in the fellow eyes of Japanese patients with unilateral neovascular AMD.METHODSSixty-six patients with unilateral neovascular AMD and abnormal FAF in the fellow eye were enrolled in this multicenter, prospective, observational study. The best-corrected visual acuity, fundus photographs, FAF images, and retinal sensitivity on microperimetry were measured periodically for 12 months. The FAF images were classified into eight patterns based on the International Fundus Autofluorescence Classification Group. The points measured by microperimetry were superimposed onto the FAF images and fundus photographs and classified as "within," "close," and "distant," based on the distance from the abnormal FAF and other findings. The relationship between the location of the baseline abnormal FAF and retinal sensitivity was investigated.RESULTSIn Japanese patients, patchy (33.3%) and focally increased (30.3%) patterns predominated in the abnormal FAF. Intermediate-to-large drusen was associated predominantly with hyperfluorescence and hypofluorescence. Neovascular AMD developed within 1 year in six (9.1%) eyes, the mean baseline retinal sensitivity of which was 12.8 ± 4.7 dB, significantly (p<0.002) lower than the other eyes. In 44 of the other 60 eyes, microperimetry was measurable at baseline and month 12 and the mean retinal sensitivity improved significantly from 13.5 ± 4.4 to 13.9 ± 4.8 dB (p<0.001), possibly associated with lifestyle changes (e.g., smoking cessation, antioxidant and zinc supplementation). The mean retinal sensitivities of points within and close to the abnormal FAF were 9.9 and 11.7 dB, respectively, which were significantly lower than the 14.0 dB of the points distant from the abnormal FAF.CONCLUSIONIn Japanese patients, patchy and focally increased patterns predominated in the abnormal FAF. The retinal sensitivity was lower close to/within the abnormal FAF. FAF and microperimetry are useful to assess macular function before development of neovascular AMD or geographic atrophy.

PLOS ONEQ3 · CROSS-FIELD

Five-year follow-up of fundus autofluorescence and retinal sensitivity in the fellow eye in exudative age-related macular degeneration in Japan

Q3 · CROSS-FIELD

ArticleOA

Author: Shinojima, Ari ; Sawa, Miki ; Kuno, Noriyuki ; Yuzawa, Mitsuko ; Matsuno, Kiyoshi ; Ishibashi, Tatsuro ; Yasukawa, Tsutomu ; Mori, Ryusaburo ; Kimura, Erika ; Ashikari, Masayuki ; Saito, Masaaki ; Hirano, Yoshio ; Hara, Chikako ; Ogura, Yuichiro ; Sekiryu, Tetsuju ; Iida, Tomohiro ; Nishiyama, Takeshi ; Nakamura, Mayumi ; Oshima, Yuji ; Gomi, Fumi ; Sugano, Yukinori ; Kato, Aki ; Asato, Hitomi

PURPOSETo assess the 5-year change in abnormal fundus autofluorescence (FAF) patterns and retinal sensitivity in the fellow eye of Japanese patients with unilateral exudative age-related macular degeneration (AMD).METHODSPatients with unilateral exudative AMD who developed abnormal FAF in the fellow eyes were enrolled. FAF imaging and microperimetry were performed at baseline and follow-ups. FAF findings were classified into 8 patterns based on the International Fundus Autofluorescence Classification Group to assess retinal sensitivity. Forty-five points covering the central 12 degrees on microperimetry were superimposed onto the FAF images. Each point was classified depending on the distance from the abnormal FAF. "Close" was defined as the portion within 1 degree from the border of any abnormal FAF, and "Distant" was defined as the portion over 1 degree from the border of abnormal FAF. To investigate the association between the retinal sensitivity and distance from the abnormal FAF, hierarchical linear mixed-effect models were used with the distance, time and time squared from baseline (months), and angle (degrees) as fixed effects. Differences among patients, eyes, and test point locations were considered successively nested random effects.RESULTSWe studied 66 fellow eyes with abnormal FAF. Twenty-seven eyes were followed-up during the 5 years. In the 13 of 27 eyes (48%), the abnormal FAF patterns had changed during the 5 years. We found retinal sensitivity was associated significantly with the distance from the abnormal FAF ("Distant": p<0.001, time2 from baseline: p<0.001, angle: p<0.001). The mean retinal sensitivity of the "Close" tended to deteriorate after the third year and eventually showed the similar sensitivity as the portion within the abnormal FAF.CONCLUSIONFAF patterns can change about half during the 5 years and the retinal sensitivity near abnormal FAF tends to deteriorate after the third year.

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