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104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft 2006
Abstract
Abstract
DO.02.07 Time-dependent visual loss in patients with extrafoveal geographic atrophy associated with AMD Mößner A.1, Bindewald-Wittich A.2, Einbock W.3, Fleckenstein M.2, Mansmann U.4, Scholl H. P. N.2, Holz F. G.2, Foja C.1, Wolf S.3 for the FAM study group
1University of Leipzig, Department of Ophthalmology, Leipzig, Germany; 2University of Bonn, Department of Ophthalmology, Bonn, Germany; 3University of Bern, Department of Ophthalmology, Inselspital, Bern, Switzerland; 4Institute for Biometry and Epidemiology (IBE), Ludwig-Maximilians-University, Munich, Germany Objective: Severe visual loss in age-related macular degeneration (AMD) results either from choroidal neovascularization, pigment epithelial detachment or from geographic atrophy (GA). As part of the prospective multicenter natural history FAM study (Fundus Autofluorescence in age-related Macular Degeneration) we analysed progression and functional outcome in eyes with advanced extrafoveal geographic atrophy (GA) and good visual acuity (VA) at baseline.
Methods: Patients with extrafoveal GA in four quadrants surrounding the foveola and ETDRS visual acuity of ³20/32 at baseline were analyzed. Examinations included ETDRS BCVA and FAF-imaging according to a standard operation procedure and using a confocal scanning laser ophthalmoscope (HRA, Heidelberg Engineering, Germany). Severe visual loss was defined as ³6 ETDRS-lines loss.
Results: 41 eyes of 37 patients (23 female, 14 male; mean age: 72.7±6.7 years) met the criteria and were analyzed. Mean observation period was 26.9±15.4 months. One year after baseline examinations (data of 25 eyes) one case showed a severe loss of VA (68% stable, 12% mild, 16% moderate). Two years data of 21 eyes showed another severe loss of VA (62% stable, 19% mild, 14% moderate). After three years (data of 13 eyes) one more eye lost ³6 ETDRS-lines (54% stable, 8% mild, 31% moderate). Four years after baseline (data of 8 eyes) again one case of severe loss of VA (50%stable, 38% moderate). A total of five eyes (12.2%) suffered from severe visual loss of ³6 ETDRS-lines during the review period.
Conclusions: While areas of atrophy progress over time the results indicate that good visual acuity may be maintained over a long period in presence of advanced extrafoveal atrophy. The data are in accordance with the concept of foveal sparing and foveolar involvement not until late in the disease process. Data from the natural history study in this subset of patients with GA may be helpful to design future interventional trials.
Supported by DFG grants: AMD Research Priority program SPP 1088, Ho 1926/1-3, HO 1926 3-1, Wo 478/10-1, MA 1723/1-1
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