Autofluorescence shows two pathways to geographic atrophy
Geographic atrophy could involve two separate disease pathways, one with soft drusen and one with subretinal drusenoid deposits, according to a study published in Eye.
R. Theodore Smith, MD, PhD, and colleagues were able to differentiate these markers in patients using quantitative autofluorescence (qAF).
“We found it was consistently twice as bright in the patients with SDDs as those with drusen when they reached advanced AMD and came from a unique diseased layer,” Smith, lead author of the study, said in a Mount Sinai press release. “Combined with our prior research, this provides conclusive evidence that two different disease processes in AMD are taking place, one with darker fluorescence and drusen, and one with brighter fluorescence and SDDs, and they need to be treated differently.”
In the study, 23 eyes of 18 participants with geographic atrophy (GA) underwent spectral-domain OCT and qAF imaging. Using OCT scans from the 3 previous years, researchers found that of 52 GA regions, 18 originated from drusen, 12 originated from subretinal drusenoid deposits (SDDs), and 22 originated from a mixture of both.
The brightness of the fluorescent lights coming from these GA regions was twice as bright in participants with SDDs (mean qAF 71.62 units) compared with participants with drusen (mean qAF 35.88 units; P < .001).
Smith said the findings show that there are two different diseases in age-related macular degeneration, one with drusen and one with SDDs.
“The good news for patients and eye specialists is that in the clinic, we will not need advanced AF measurements to know which form of AMD the patient has,” he said in the release. “As our research showed, the two forms are associated with drusen and SDDs, and those deposits can be identified by standard retinal imaging. It therefore becomes important to diagnose which form of AMD the patient has for treatment and prevention of disease.”
Reference:
- Mount Sinai researchers first to identify that two separate eye diseases may contribute to common blinding eye condition. https://www.mountsinai.org/about/newsroom/2023/mount-sinai-researchers-first-to-identify-that-two-separate-eye-diseases-may-contribute-to-common-blinding-eye-condition. Published Jan. 9, 2023. Accessed Jan. 13, 2023.
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