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    Fundus Autofluorescence in Age-related Macular Degeneration

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    Author
    Ly, A; Nivison-Smith, L; Assaad, N; Kalloniatis, M
    Date
    2017-02-01
    Source Title
    Optometry and Vision Science
    Publisher
    LIPPINCOTT WILLIAMS & WILKINS
    University of Melbourne Author/s
    Kalloniatis, Michael
    Affiliation
    Anatomy and Neuroscience
    Metadata
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    Document Type
    Journal Article
    Citations
    Ly, A., Nivison-Smith, L., Assaad, N. & Kalloniatis, M. (2017). Fundus Autofluorescence in Age-related Macular Degeneration. OPTOMETRY AND VISION SCIENCE, 94 (2), pp.246-259. https://doi.org/10.1097/OPX.0000000000000997.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/256677
    DOI
    10.1097/OPX.0000000000000997
    Abstract
    : Fundus autofluorescence (FAF) provides detailed insight into the health of the retinal pigment epithelium (RPE). This is highly valuable in age-related macular degeneration (AMD) as RPE damage is a hallmark of the disease. The purpose of this paper is to critically appraise current clinical descriptions regarding the appearance of AMD using FAF and to integrate these findings into a chair-side reference. A wide variety of FAF patterns have been described in AMD, which is consistent with the clinical heterogeneity of the disease. In particular, FAF imaging in early to intermediate AMD has the capacity to reveal RPE alterations in areas that appear normal on funduscopy, which aids in the stratification of cases and may have visually significant prognostic implications. It can assist in differential diagnoses and also represents a reliable, sensitive method for distinguishing reticular pseudodrusen. FAF is especially valuable in the detection, evaluation, and monitoring of geographic atrophy and has been used as an endpoint in clinical trials. In neovascular AMD, FAF reveals distinct patterns of classic choroidal neovascularization noninvasively and may be especially useful for determining which eyes are likely to benefit from therapeutic intervention. FAF represents a rapid, effective, noninvasive imaging method that has been underutilized, and incorporation into the routine assessment of AMD cases should be considered. However, the practicing clinician should also be aware of the limitations of the modality, such as in the detection of foveal involvement and in the distinction of phenotypes (hypo-autofluorescent drusen from small areas of geographic atrophy).

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