Ultra-widefield fundus autofluorescence in age-related macular degenerationReport as inadecuate

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Establish accuracy and reproducibility of subjective grading in ultra-widefield fundus autofluorescence FAF imaging in patients with age-related macular degeneration AMD, and determine if an association exists between peripheral FAF abnormalities and AMD.


This was a prospective, single-blinded case-control study. Patients were consecutively recruited for the study. Patients were excluded if there was a history of prior or active ocular pathology other than AMD or image quality was insufficient for analysis as determined by two independent graders. Control patients were those without any evidence of AMD or other ophthalmic disease apart from cataract. Using the Optos 200Tx Optos, Marlborough, MA, USA, a ResMax central macula and an ultra-widefield peripheral retina image was taken for each eye in both normal color and short wavelength FAF. Ultra-widefield photographs were modified to mask the macula. Each ResMax and ultra-widefield image was independently graded by two blinded investigators.


There were 28 AMD patients and 11 controls. There was a significant difference in the average age between AMD patients and control groups 80 versus 64, respectively P<0.001. There was moderate, statistically significant agreement between observers regarding image interpretation 78.4%, K = 0.524, P<0.001, and 69.0% K = 0.49, P<0.001 agreement between graders for FAF abnormality patterns. Patients with AMD were at greater risk for peripheral FAF abnormalities OR: 3.43, P = 0.019 and patients with FAF abnormalities on central macular ResMax images were at greater risk of peripheral FAF findings OR: 5.19, P = 0.017.


Subjective interpretation of FAF images has moderate reproducibility and validity in assessment of peripheral FAF abnormalities. Peripheral FAF abnormalities are seen in both AMD and control patients. Those with AMD, poor visual acuity, and macular FAF abnormalities are at greater risk.

Author: Abhilash Guduru , David Fleischman , Sunyoung Shin, Donglin Zeng, James B. Baldwin, Odette M. Houghton , Emil A. Say

Source: http://plos.srce.hr/


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