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

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

Tsutomu Yasukawa  1 , Ryusaburo Mori  2 , Miki Sawa  3 , Ari Shinojima  2 , Chikako Hara  3 , Tetsuju Sekiryu  4 , Yuji Oshima  5 , Masaaki Saito  4   6 , Yukinori Sugano  4 , Aki Kato  1 , Masayuki Ashikari  1 , Yoshio Hirano  1 , Hitomi Asato  5 , Mayumi Nakamura  7 , Kiyoshi Matsuno  7 , Noriyuki Kuno  7   8 , Erika Kimura  7 , Takeshi Nishiyama  9 , Mitsuko Yuzawa  2 , Tatsuro Ishibashi  5 , Yuichiro Ogura  1 , Tomohiro Iida  4   10 , Fumi Gomi  3   11
Affiliations
Observational Study

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

Tsutomu Yasukawa et al. PLoS One. .

Abstract

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.

PubMed Disclaimer

Conflict of interest statement

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]. Mayumi Nakamura, Kiyoshi Matsuno, Noriyuki Kuno, and Erika Kimura are(were) employees of Santen Pharmaceutical Co., Ltd. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Flow chart for classifying abnormal FAF.
Fig 2
Fig 2. Changes in the mean BCVA logMAR and mean retinal sensitivity during the follow-up period.
The data are expressed as the mean ± standard error of the mean. *P<0.01 compared with baseline (paired t-test).
Fig 3
Fig 3. The relationship between retinal sensitivity and the distance from the abnormal FAF.
(A) The temporal changes in the mean retinal sensitivity in three groups. (†P<0.01 vs. close at each time point, ANOVA). (B) The changes in the mean retinal sensitivity from baseline in the three groups. The data are expressed as the mean ± standard error of the mean. (*P<0.05 and **P<0.01 as compared with baseline, paired t-test).
Fig 4
Fig 4. The proportion of points with a 4-dB or greater decline in the groups in which the distances to the abnormal FAF differed (P = 0.113, Fisher’s exact test).
Fig 5
Fig 5. The impact of supplementation on the mean retinal sensitivity.
(A) The temporal changes in the mean retinal sensitivity in groups with and without supplementation. (B) The changes in the mean retinal sensitivity from baseline. (†P<0.01, ANOVA; *P<0.01 compared with baseline, paired t-test).
See this image and copyright information in PMC

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