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. 2020 Mar 6;15(3):e0229694.
doi: 10.1371/journal.pone.0229694. eCollection 2020.

Five-year follow-up of fundus autofluorescence and retinal sensitivity in the fellow eye in exudative age-related macular degeneration in Japan

Ari Shinojima  1   2 , Miki Sawa  3 , Ryusaburo Mori  1 , Tetsuju Sekiryu  4 , Yuji Oshima  5 , Aki Kato  6 , Chikako Hara  3 , Masaaki Saito  4   7 , Yukinori Sugano  4 , Masayuki Ashikari  6 , Yoshio Hirano  6 , Hitomi Asato  5 , Mayumi Nakamura  8 , Kiyoshi Matsuno  8 , Noriyuki Kuno  8   9 , Erika Kimura  8 , Takeshi Nishiyama  10 , Mitsuko Yuzawa  1 , Tatsuro Ishibashi  5 , Yuichiro Ogura  6 , Tomohiro Iida  4   11 , Fumi Gomi  3   12 , Tsutomu Yasukawa  6
Affiliations

Five-year follow-up of fundus autofluorescence and retinal sensitivity in the fellow eye in exudative age-related macular degeneration in Japan

Ari Shinojima et al. PLoS One. .

Abstract

Purpose: To assess the 5-year change in abnormal fundus autofluorescence (FAF) patterns and retinal sensitivity in the fellow eye of Japanese patients with unilateral exudative age-related macular degeneration (AMD).

Methods: Patients with unilateral exudative AMD who developed abnormal FAF in the fellow eyes were enrolled. FAF imaging and microperimetry were performed at baseline and follow-ups. FAF findings were classified into 8 patterns based on the International Fundus Autofluorescence Classification Group to assess retinal sensitivity. Forty-five points covering the central 12 degrees on microperimetry were superimposed onto the FAF images. Each point was classified depending on the distance from the abnormal FAF. "Close" was defined as the portion within 1 degree from the border of any abnormal FAF, and "Distant" was defined as the portion over 1 degree from the border of abnormal FAF. To investigate the association between the retinal sensitivity and distance from the abnormal FAF, hierarchical linear mixed-effect models were used with the distance, time and time squared from baseline (months), and angle (degrees) as fixed effects. Differences among patients, eyes, and test point locations were considered successively nested random effects.

Results: We studied 66 fellow eyes with abnormal FAF. Twenty-seven eyes were followed-up during the 5 years. In the 13 of 27 eyes (48%), the abnormal FAF patterns had changed during the 5 years. We found retinal sensitivity was associated significantly with the distance from the abnormal FAF ("Distant": p<0.001, time2 from baseline: p<0.001, angle: p<0.001). The mean retinal sensitivity of the "Close" tended to deteriorate after the third year and eventually showed the similar sensitivity as the portion within the abnormal FAF.

Conclusion: FAF patterns can change about half during the 5 years and the retinal sensitivity near abnormal FAF tends to deteriorate after the third year.

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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. The proportions of FAF patterns.
Top: all FAF patterns of 66 eyes at baseline. Middle: FAF patterns at baseline of 27 eyes which were followed-up during the 5 years. Bottom: the final FAF patterns of 27 eyes at the 5th year. The numbers within graphs show the actual number of the eye.
Fig 2
Fig 2. Transition of mean retinal sensitivity by each pattern of abnormal FAF during the 5 years.
The number of each pattern differs at each time-point compared to baseline (cf. Fig 1). The sensitivity of the linear, focal plaque-like, patchy, and speckled FAF pattern decreased significantly compared to the baseline at the 5th year. The speckled FAF pattern at the 5th year had the lowest mean retinal sensitivity. The sensitivity of lace-like increased significantly compared to baseline at the 5th year. Data are expressed as mean ± standard error (SE). * P < 0.05 compared to baseline, paired t-test. BL: baseline.
Fig 3
Fig 3. The association between the mean retinal sensitivity and the distance from the abnormal FAF (1,215 points per year).
Total 1,215 points were classified as “Within” (within abnormal FAF), “Close” (within 1 degree from the border of abnormal FAF), and “Distant” (over 1 degree from the border of abnormal FAF). Data are expressed as mean ± SE.
Fig 4
Fig 4. A representative case of FAF imaging and color fundus imaging.
A 66-year-old man. The focal increase FAF pattern was seen at baseline, and the mean retinal sensitivity was 12.2 dB. In 3 years, the portion showing hyperfluorescence at baseline changed to hypofluorescence in part, and the hyperfluorescence expanded and changed to the patchy pattern. In the fundus photograph, drusen increased during the 5 years. The mean retinal sensitivity was 13.4 dB at the 3rd year and 9.5 dB at the 5th year.
See this image and copyright information in PMC

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