Geographic Atrophy of the Retinal Pigment Epithelium

Blair, Charles J.

doi:10.1001/archopht.1975.01010020023003

Cited by 71 publications

(14 citation statements)

References 10 publications

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“…Geographic atrophy (GA) represents the late stage of dry age-related macular degeneration (AMD) [1,2,3,4,5]. GA is present in 3.5% of people over 75 years [6,7] and becomes the predominant phenotypic manifestation of AMD in the population of 85 years and older [8].…”

Section: Introductionmentioning

confidence: 99%

Modeling Visual Acuity in Geographic Atrophy Secondary to Age-Related Macular Degeneration

Schmitz-Valckenberg¹,

Nadal

Fimmers

et al. 2016

Ophthalmologica

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Purpose: To analyze and model visual acuity (VA) in geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Methods: The course of VA was analyzed using Turnbull's estimator in 226 eyes with uni- or bilateral GA due to AMD (151 patients; mean age 74.0 ± 7.6 years; mean follow-up time 33.4 ± 23.4 months) from the natural history FAM (Fundus-Autofluorescence Imaging in AMD) study. The variables ‘age at baseline', ‘gender', ‘lesion size', ‘diagnosis of the fellow eye', ‘status of the fovea', ‘focality of the lesion' and ‘pattern' were evaluated for effects on predicting VA using linear mixed-effects models. Results: Mean VA at baseline was0.6 (Snellen 20/80) ± 0.4 logMAR [range -0.1 to 1.8 (20/17 to hand motions)], showing an estimated mean increase of 0.181 (95% CI 0.152-0.210) and 0.256 (0.214-0.300) after 2 and 4 years of follow-up, respectively. The percentage of eyes with a loss of ≥3 lines was 34% by 2 years and 47% by 4 years. Linear mixed model analysis suggested that 65% of VA variability could be explained by the assessed predictor variables. The strongest effect was found for the ‘status of the fovea' (0.69 logMAR units between ‘definitively spared fovea' and ‘definitive foveal involvement', p < 0.001). The second strongest effect was identified for ‘total lesion size' (effects between 0.02 and 0.09 logMAR units for each mm depending on foveal involvement, p < 0.001, square root transformed values). Conclusions: These findings underscore the importance of GA lesion characteristics as these have the strongest impact on VA. Natural history data and modeling VA to other variables will be helpful for refining outcome parameters and estimating possible benefits of therapeutic interventions.

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Section: Introductionmentioning

confidence: 99%

Modeling Visual Acuity in Geographic Atrophy Secondary to Age-Related Macular Degeneration

Schmitz-Valckenberg¹,

Nadal

Fimmers

et al. 2016

Ophthalmologica

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“…Since both these hereditary macular dystrophies are inherited in an autosomal dominant manner (Sandvig, 1955;Carr, 1965), the differential is best made by the abnormal electro-oculogram in vitelliform macular dystrophy. The differential diagnosis of bilateral central choroidal atrophy has been previously discussed (Noble, 1977) and includes Stargardt's disease (Irvine and Wergeland, 1972), dominant progressive cone dystrophy (Krill and Deutman, 1972), acquired macular degenerations (geographic atrophy of the retinal pigment epithelium) (Blair, 1975), geographic (Schatz et al, 1974), serpiginous (Gass, 1977, p. 112) choroidopathy, and chorioretinal inflammations (macular 'coloboma').…”

Section: Discussionmentioning

confidence: 99%

Polymorphous presentations in vitelliform macular dystrophy: subretinal neovascularisation and central choroidal atrophy.

Noble¹,

Scher²,

Carr³

1978

British Journal of Ophthalmology

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SUMMARY Two dominantly inherited macular dystrophies demonstrate the difficulty in establishing a diagnosis based on the fundus appearance. In 1 family the propositus presented with unilateral retinal haemorrhage associated with subretinal choroidal neovascularisation which remained unilateral over an 8-year period. In the other family the propositus presented with bilateral central choroidal atrophy. All affected family members had an abnormal electro-oculogram and a normal electroretinogram, suggesting the diagnosis of vitelliform macular dystrophy. Since vitelliform macular dystrophy has a wide range of expressivity, with polymorphous appearances of the fundus, the diagnosis is best made by the presence of a dominant mode of inheritance and an abnormal electro-oculogram.

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“…The first publication using the term “geographic atrophy” in its title was an article by Charles J. Blair (Bascom Palmer Eye Institute in Miami) published in 1975 49 . He described 11 patients with “geographic atrophy of the retinal pigment epithelium secondary to senile macular degeneration”.…”

Section: Review Of the Ophthalmological Literaturementioning

confidence: 99%

“…This slight difference in terminology appears to be more related to British versus American English which was indeed confirmed by Sarks in 2016 (personal communication). Sarks did not use the adjunct “of the retinal pigment epithelium” (Blair 1975) or “of the pigment epithelium and choroid” (Gass 1977) 47, 49 . In this article, Sarks described a clinico-pathological study on 378 eyes of subjects who had been admitted to a hospital for aged homeless men in Australia.…”

Section: Review Of the Ophthalmological Literaturementioning

confidence: 99%

Geographic Atrophy

Schmitz-Valckenberg

Sadda

Staurenghi

et al. 2016

Retina

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Purpose There is a lack of agreement regarding the types of lesions and clinical conditions that should be included in the term “geographic atrophy”. Varied and conflicting views prevail throughout the literature and are currently used by retinal experts and other health care professionals. Methods We reviewed the nominal definition of the term “geographic atrophy” and conducted a search of the ophthalmological literature focusing on preceding terminologies as well as the first citations of the term “geographic atrophy” secondary to age-related macular degeneration (AMD). Results According to the nominal definition, the term “geography” stands for a detailed description of the surface features of a specific region, indicating its relative position. However, it does not necessarily imply that the borders of the region must be sharply demarcated or related to any anatomical structures. The term “geographical areas of atrophy” was initially cited in the 1960s in the ophthalmological literature in the context of uveitic eye disease and shortly thereafter also for the description of variants of “senile macular degeneration”. However, no direct explanation could be found in the literature as to why the terms “geographical” and “geographic” were chosen. Presumably the terms were used as the atrophic regions resembled the map of a continent or well-defined country borders on thematic geographical maps. With the evolution of the terminology, the commonly used adjunct “of the retinal pigment epithelium” was frequently omitted and solely the term “geographic atrophy” prevailed for the non-exudative late-stage of AMD itself. Along with the quantification of atrophic areas, based on different imaging modalities and the use of both manual and semi-automated approaches, various and inconsistent definitions for the minimal lesion diameter or size of atrophic lesions have also emerged. Conclusions Reconsideration of the application of the term “geographic atrophy” in the context of AMD appears to be prudent given ongoing advances in multi-modal retinal imaging technology with identification of various phenotypic characteristics, and the observation of atrophy development in eyes under anti-angiogenic therapy.

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Geographic Atrophy of the Retinal Pigment Epithelium

Cited by 71 publications

References 10 publications

Modeling Visual Acuity in Geographic Atrophy Secondary to Age-Related Macular Degeneration

Modeling Visual Acuity in Geographic Atrophy Secondary to Age-Related Macular Degeneration

Polymorphous presentations in vitelliform macular dystrophy: subretinal neovascularisation and central choroidal atrophy.

Geographic Atrophy

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