Fundus Autofluorescence in Extensive Macular Atrophy With Pseudodrusen and Diffuse Trickling Geographic Atrophy

Bianco, Lorenzo; Antropoli, Alessio; Arrigo, Alessandro; Berni, Alessandro; Franca, Lamberto La; Saladino, Andrea; Bandello, Francesco; Parodi, Maurizio Battaglia

doi:10.1097/iae.0000000000003733

Retina

2023

DOI: 10.1097/iae.0000000000003733

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Fundus Autofluorescence in Extensive Macular Atrophy With Pseudodrusen and Diffuse Trickling Geographic Atrophy

Lorenzo Bianco

Alessio Antropoli

Alessandro Arrigo

et al.

Abstract: Extensive macular atrophy with pseudodrusen shows remarkable clinical and imaging similarities with the diffuse-trickling pattern of geographic atrophy. Using a quantitative approach, we investigated whether extensive macular atrophy with pseudodrusen and diffuse-trickling pattern of geographic atrophy can be distinguished using blue-light autofluorescence.

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Cited by 5 publications

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Extensive macular atrophy with pseudodrusen-like appearance: comprehensive review of the literature

Carlà,

Giannuzzi,

Boselli

et al. 2024

Graefes Arch Clin Exp Ophthalmol

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Purpose This review focuses on extensive macular atrophy with pseudodrusen-like appearance (EMAP), a recently described maculopathy presenting with pseudodrusen-like lesions and chorioretinal atrophy more pronounced in the vertical axis. Methods Narrative review of the literature published until May 2024. Results The early onset age of EMAP (50–55 years) and its distinctive natural history, which includes night blindness followed by severe vision loss, differentiate it from atrophic age-related macular degeneration (AMD). A clear pathogenesis has not been determined, but risk factors include female gender and complement system abnormalities (altered levels of C3 and CH50). Moreover, lifelong exposure to pesticides has been suggested as risk factor for direct neuronal degeneration involving rods and cones. In the early phase of the disease, reticular pseudodrusen-like lesions appear in the superior perifovea and tend to coalescence horizontally into a flat, continuous, reflective material localized between the retinal pigmented epithelium and Bruch’s membrane. Over time, EMAP causes profound RPE and outer retinal atrophy in the macular area, with a recent classification reporting a 3-stages evolution pattern. Blue autofluorescence showed rapidly evolving atrophy with either hyperautofluorescent or isoautofluorescent borders. Significant similarities between the diffuse-trickling phenotype of geographic atrophy and EMAP have been reported. Macular neovascularization is a possible complication. Conclusion EMAP is specific form of early-onset atrophic macular degeneration with rapid evolution and no treatment. Further studies are needed to assess the best management.

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Extensive macular atrophy with pseudodrusen-like appearance: comprehensive review of the literature

Carlà,

Giannuzzi,

Boselli

et al. 2024

Graefes Arch Clin Exp Ophthalmol

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Progression Rate of Macular Retinal Pigment Epithelium Atrophy in Geographic Atrophy and Selected Inherited Retinal Dystrophies. A Systematic Review and Meta-Analysis

Bassil,

Colijn,

Thiadens

et al. 2025

American Journal of Ophthalmology

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Small Hyperreflective Retinal Foci as in vivo imaging feature of resident microglia activation in geographic atrophy

Pilotto,

Parolini,

Midena

et al. 2024

Experimental Eye Research

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Fundus Autofluorescence in Extensive Macular Atrophy With Pseudodrusen and Diffuse Trickling Geographic Atrophy

Cited by 5 publications

References 28 publications

Extensive macular atrophy with pseudodrusen-like appearance: comprehensive review of the literature

Extensive macular atrophy with pseudodrusen-like appearance: comprehensive review of the literature

Progression Rate of Macular Retinal Pigment Epithelium Atrophy in Geographic Atrophy and Selected Inherited Retinal Dystrophies. A Systematic Review and Meta-Analysis

Small Hyperreflective Retinal Foci as in vivo imaging feature of resident microglia activation in geographic atrophy

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