Fundus autofluorescence and microperimetry in progressing geographic atrophy secondary to age-related macular degeneration

Abstract

SW-FAF, compared with NIR-FAF, underestimates GA area at baseline and at follow-up. The enlargement rate of progression based on NIR-FAF is not greater than on SW-FAF. Different SW-FAF and NIR-FAF patterns show different relative risk of progression from relative to dense scotoma. Microperimetry, SW-FAF and NIR-FAF should be combined to obtain adequate morphological and functional prospective information.

Intrasession Test–Retest Variability of Microperimetry in Age-Related Macular Degeneration

“…Averaged values are useful in providing an overall representation of the retinal sensitivity over the area averaged, and reduce the test-retest confidence limits in a similar way to obtaining multiple measurements over the sampled area. Depending on the spatial density and size of the stimulus, averaged values may underestimate localized pathological changes that occur in AMD, 6,[8][9][10][23][24][25][26][27] such as areas that subsequently develop GA 11 or the expansion of a slow-progressing atrophic lesion. 21 This is particularly important when the distance between each test stimulus is larger than the size of the lesion of interest, or the expected rate of progression.…”

Retinal Sensitivity and Fixation Stability Changes during Repeated Microperimetry

“…With microperimetry biofeedback training, patients with macular diseases who have lost foveal fixation capabilities are trained to relocate their preferred retinal locus (PRL) into an area with better sensitivity. This training to relocate the PRL can improve the fixation behavior and, thereby, visual performance [21][22][23]24,25]. Several authors have demonstrated that this training is effective in patients with loss of central vision secondary to macular pathologies, particularly in cases with geographic atrophy secondary to AMD [21,23,24,26]; however, it has also been reported that patients with macular disease may use two or more PRLs for fixation [24,25,27].…”

“…This training to relocate the PRL can improve the fixation behavior and, thereby, visual performance [21][22][23]24,25]. Several authors have demonstrated that this training is effective in patients with loss of central vision secondary to macular pathologies, particularly in cases with geographic atrophy secondary to AMD [21,23,24,26]; however, it has also been reported that patients with macular disease may use two or more PRLs for fixation [24,25,27]. In our study during three examinations, the fixation stability improved in the better eye of AMD patients, but the stable consistency and accuracy in fixation stability on the same fixation location (same retinal locus/correct choice of the new fixation point [PRL] required more tests and biofeedback trainings.…”

Combined Angiography for High-Quality Near-Infrared Autofluorescence Images

“…Particularly, in dry AMD, it has been suggested that NIA allows better detection of impairment of photoreceptors and RPE and geographic atrophy enlargement than blue FAF 9,10 It is noteworthy that images acquired with either HRA2 or Spectralis HRA + OCT (i.e., different devices) gave approximately the same results. 9,10 In conclusion, we illustrated a less expensive solution to obtain NIA images than purchasing a separate HRA2 instrument. Future studies will compare the NIA images obtained with Spectralis HRA + OCT with those obtained with HRA2.…”