Progression of Atrophy and Visual Outcomes in Extensive Macular Atrophy with Pseudodrusen-like Appearance

• DOI: 10.1016/j.xops.2021.100016
• Publication Date: 2021-03-20T13:14:13Z
• Authors: Francesco Romano; Matteo Airaldi; Mariano Cozzi; Marta Oldani; Ester Riva; Alice Ingrid Bertoni; Astrit Dautaj; Matteo Bertelli; Giovanni Staurenghi; Anna Paola Salvetti
• Keywords: Fundus (uterus)

To report visual outcomes and rate of retinal pigment epithelium (RPE) atrophy progression in patients with extensive macular pseudodrusen-like appearance (EMAP).Retrospective, observational study.Patients EMAP symptom onset before 55 years age, at least 12 months follow-up using Spectralis blue-light fundus autofluorescence (BAF) OCT no other ocular or systemic conditions.Best-corrected acuity (BCVA), BAF, images were reviewed baseline each annual visit until the last available follow-up. Atrophy was measured by 2 graders region finder software on Heidelberg Explorer confirmed scans covering entire atrophic lesion. The following imaging biomarkers analyzed visit: foveal atrophy, vitreomacular traction, outer tubulations, choroidal caverns subfoveal thickness, border pattern (hyper-autofluorescent iso-autofluorescent), irregularity as expressed circularity index (CI).Primary enlargement BCVA loss patients. Secondary included assessment potential factors able to predict disease progression.Thirty-six eyes from 18 (6 men [33%]; mean age onset, 48.1 ± 1.7 years) included. Mean lasted 32.8 14.3 months. RPE increased 10.8 6.3 mm2 18.1 8.3 end follow-up, a 2.91 1.09 mm2/year. Faster associated smaller CI (P = 0.02) iso-autofluorescent lesion borders 0.01). Visual declined progressively 7.4 5.8 letters per year, 57% showing vision 20/200 Snellen worse 4-year Worse observed early involvement 0.02).Patients affected present rapid expansion that is comparable diffuse-trickling form geographic atrophy. More irregular seem faster progression. Our findings may provide relevant information for patient counseling future interventional approaches select best candidates proper clinical outcomes.