PMID- 21496928
OWN - NLM
STAT- MEDLINE
DCOM- 20111024
LR  - 20220310
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
VI  - 118
IP  - 9
DP  - 2011 Sep
TI  - A systematic comparison of spectral-domain optical coherence tomography and 
      fundus autofluorescence in patients with geographic atrophy.
PG  - 1844-51
LID - 10.1016/j.ophtha.2011.01.043 [doi]
AB  - PURPOSE: To evaluate spectral-domain optical coherence tomography (SD-OCT) in 
      providing reliable and reproducible parameters for grading geographic atrophy 
      (GA) compared with fundus autofluorescence (FAF) images acquired by confocal 
      scanning laser ophthalmoscopy (cSLO). DESIGN: Prospective observational study. 
      PARTICIPANTS: A total of 81 eyes of 42 patients with GA. METHODS: Patients with 
      atrophic age-related macular degeneration (AMD) were enrolled on the basis of 
      total GA lesion size ranging from 0.5 to 7 disc areas and best-corrected visual 
      acuity of at least 20/200. A novel combined cSLO-SD-OCT system (Spectralis 
      HRA-OCT, Heidelberg Engineering, Heidelberg, Germany) was used to grade foveal 
      involvement and to manually measure disease extent at the level of the outer 
      neurosensory layers and retinal pigment epithelium (RPE) at the site of GA 
      lesions. Two readers of the Vienna Reading Center graded all obtained volume 
      stacks (20x20 degrees), and the results were correlated to FAF. MAIN OUTCOME 
      MEASURES: Choroidal signal enhancements and alterations of the RPE, external 
      limiting membrane (ELM), and outer plexiform layer by SD-OCT. These parameters 
      were compared with the lesion measured with severely decreased FAF. RESULTS: 
      Foveal involvement or sparing was definitely identified in 75 of 81 eyes based on 
      SD-OCT by both graders (inter-grader agreement: kappa=0.6, P < 0.01). In FAF, 
      inter-grader agreement regarding foveal involvement was lower (48/81 eyes, 
      inter-grader agreement: kappa=0.3, P < 0.01). Severely decreased FAF was measured 
      over a mean area of 8.97 mm(2) for grader 1 (G1) and 9.54 mm(2) for grader 2 
      (G2), consistent with the mean SD-OCT quantification of the sub-RPE choroidal 
      signal enhancement (8.9 mm(2) [G1] -9.4 mm(2) [G2]) and ELM loss with 8.7 mm(2) 
      (G1) -10.2 mm(2) (G2). In contrast, complete morphologic absence of the RPE layer 
      by SD-OCT was significantly smaller than the GA size in FAF (R(2)=0.400). 
      Inter-reader agreement was highest regarding complete choroidal signal 
      enhancement (0.98) and ELM loss (0.98). CONCLUSIONS: Absence of FAF in GA lesions 
      is consistent with morphologic RPE loss or advanced RPE disruption and is 
      associated with alterations of the outer retinal layers as identified by SD-OCT. 
      Lesion size is precisely determinable by SD-OCT, and foveal involvement is more 
      accurate by SD-OCT than by FAF.
CI  - Copyright (c) 2011 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Sayegh, Ramzi G
AU  - Sayegh RG
AD  - Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
FAU - Simader, Christian
AU  - Simader C
FAU - Scheschy, Ulrike
AU  - Scheschy U
FAU - Montuoro, Alessio
AU  - Montuoro A
FAU - Kiss, Christopher
AU  - Kiss C
FAU - Sacu, Stefan
AU  - Sacu S
FAU - Kreil, David P
AU  - Kreil DP
FAU - Prunte, Christian
AU  - Prunte C
FAU - Schmidt-Erfurth, Ursula
AU  - Schmidt-Erfurth U
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20110415
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Epiretinal Membrane/diagnosis
MH  - Female
MH  - *Fluorescein Angiography
MH  - Follow-Up Studies
MH  - Fovea Centralis/pathology
MH  - Geographic Atrophy/*diagnosis
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Observer Variation
MH  - Ophthalmoscopy
MH  - Prospective Studies
MH  - Reproducibility of Results
MH  - Retinal Pigment Epithelium/*pathology
MH  - *Tomography, Optical Coherence
MH  - Visual Acuity/physiology
EDAT- 2011/04/19 06:00
MHDA- 2011/10/25 06:00
CRDT- 2011/04/19 06:00
PHST- 2010/01/08 00:00 [received]
PHST- 2011/01/13 00:00 [revised]
PHST- 2011/01/13 00:00 [accepted]
PHST- 2011/04/19 06:00 [entrez]
PHST- 2011/04/19 06:00 [pubmed]
PHST- 2011/10/25 06:00 [medline]
AID - S0161-6420(11)00077-7 [pii]
AID - 10.1016/j.ophtha.2011.01.043 [doi]
PST - ppublish
SO  - Ophthalmology. 2011 Sep;118(9):1844-51. doi: 10.1016/j.ophtha.2011.01.043. Epub 
      2011 Apr 15.