Fundus autofluorescence and retinal sensitivity in fellow eyes of age-related macular degeneration in Japan

PLoS One. 2019 Feb 28;14(2):e0213161. doi: 10.1371/journal.pone.0213161. eCollection 2019.


Purpose: Abnormal fundus autofluorescence (FAF) potentially precedes onset of late age-related macular degeneration (AMD) in Caucasian patients. Many differences exist between Asian and Caucasian patients regarding AMD types and severity, gender, and genetic backgrounds. We investigated the characteristics of abnormal FAF and retinal sensitivity in the fellow eyes of Japanese patients with unilateral neovascular AMD.

Methods: Sixty-six patients with unilateral neovascular AMD and abnormal FAF in the fellow eye were enrolled in this multicenter, prospective, observational study. The best-corrected visual acuity, fundus photographs, FAF images, and retinal sensitivity on microperimetry were measured periodically for 12 months. The FAF images were classified into eight patterns based on the International Fundus Autofluorescence Classification Group. The points measured by microperimetry were superimposed onto the FAF images and fundus photographs and classified as "within," "close," and "distant," based on the distance from the abnormal FAF and other findings. The relationship between the location of the baseline abnormal FAF and retinal sensitivity was investigated.

Results: In Japanese patients, patchy (33.3%) and focally increased (30.3%) patterns predominated in the abnormal FAF. Intermediate-to-large drusen was associated predominantly with hyperfluorescence and hypofluorescence. Neovascular AMD developed within 1 year in six (9.1%) eyes, the mean baseline retinal sensitivity of which was 12.8 ± 4.7 dB, significantly (p<0.002) lower than the other eyes. In 44 of the other 60 eyes, microperimetry was measurable at baseline and month 12 and the mean retinal sensitivity improved significantly from 13.5 ± 4.4 to 13.9 ± 4.8 dB (p<0.001), possibly associated with lifestyle changes (e.g., smoking cessation, antioxidant and zinc supplementation). The mean retinal sensitivities of points within and close to the abnormal FAF were 9.9 and 11.7 dB, respectively, which were significantly lower than the 14.0 dB of the points distant from the abnormal FAF.

Conclusion: In Japanese patients, patchy and focally increased patterns predominated in the abnormal FAF. The retinal sensitivity was lower close to/within the abnormal FAF. FAF and microperimetry are useful to assess macular function before development of neovascular AMD or geographic atrophy.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Asians
  • Disease Progression
  • Female
  • Fluorescein Angiography
  • Fundus Oculi
  • Humans
  • Japan
  • Macular Degeneration / diagnosis*
  • Macular Degeneration / pathology
  • Macular Degeneration / physiopathology
  • Male
  • Middle Aged
  • Prospective Studies
  • Retina / physiopathology
  • Retinal Drusen / diagnosis
  • Time Factors

Grant support

We declare that Santen Pharmaceutical Co., Ltd. provided venue hire charges for discussion of data interpretation and that Japan Innovative Therapeutics, Inc. provided no specific funding for this work. The coauthors, Mayumi Nakamura, Kiyoshi Matsuno, Noriyuki Kuno, and Erika Kimura from Santen Pharmaceutical Co., Ltd. played a role in data collection as a coauthor. Santen Pharmaceutical Co., Ltd. provided support in the form of honoraria for speaking and/or organizing at meetings [TY, RM, MS, AS, TS, Yuji Oshima, TI, Yuichiro Ogura, TI, FG], but did not have any additional role in the study design, data analysis, decision to publish, or preparation of the manuscript.