Egger Daniel, Doll Barbara, Gonzalez Corinne, Ahmadzai Philipp, Heger Katharina A, Kreid Barbara, Montuoro Alessio, Link Jasmin, Yamaguchi Taffeta Chingning, Esmaeelpour Marieh, Waldstein Sebastian M
Department of Ophthalmology, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria.
Karl Landsteiner University of Health Sciences, Krems, Austria.
Acta Ophthalmol. 2025 Jun;103(4):e204-e212. doi: 10.1111/aos.17431. Epub 2024 Dec 18.
To assess the impact of the ratio between photoreceptor (PR) loss and retinal pigment epithelium (RPE) loss on the progression of geographic atrophy (GA) and to explore correlations between abnormal fundus autofluorescence (FAF) patterns and the PR-RPE loss ratio.
Single-centre, retrospective case series.
Multimodal images from 87 treatment-naïve patients with GA and a follow-up of 6-24 months were included. Geographic atrophy areas on FAF images and areas of PR-RPE loss on optical coherence tomography images at baseline were manually annotated, and FAF patterns were classified. The impact of these biomarkers on GA progression through month 24 as measured on FAF was evaluated using random slope and intercept models and Spearman correlation coefficients (ρ).
Mean square-root GA growth rate was 0.27 ± 0.28 mm per year. Mean PR-RPE loss ratio at baseline was 2.16 ± 1.75. Fundus autofluorescence patterns "diffuse" and "diffuse trickling" showed higher PR-RPE loss ratios at baseline and contributed statistically significantly to the slope of GA progression (p = 0.01 and p = 0.0019). Baseline GA lesion size was negatively correlated to PR-RPE loss ratios at baseline (ρ = -0.47, p < 0.0001). Overall, GA growth was higher in patients with higher PR-RPE loss ratios at baseline (ρ = 0.35, p = 0.0011), and the ratio's contribution to the slope of GA progression was statistically significant (p = 0.0001).
Eyes with higher PR-RPE loss ratios were more likely to exhibit FAF patterns "diffuse" and "diffuse trickling" and showed higher GA progression rates. Baseline characteristics derived from FAF and OCT images may thus offer information on lesion progression.
评估光感受器（PR）丢失与视网膜色素上皮（RPE）丢失之比对地图样萎缩（GA）进展的影响，并探讨异常眼底自发荧光（FAF）模式与PR-RPE丢失比之间的相关性。
单中心回顾性病例系列研究。
纳入87例未经治疗的GA患者的多模态图像，并进行6至24个月的随访。在基线时，人工标注FAF图像上的地图样萎缩区域和光学相干断层扫描图像上的PR-RPE丢失区域，并对FAF模式进行分类。使用随机斜率和截距模型以及Spearman相关系数（ρ）评估这些生物标志物对24个月内通过FAF测量的GA进展的影响。
GA的年均平方根增长率为0.27±0.28mm。基线时PR-RPE丢失比的平均值为2.16±1.75。眼底自发荧光模式“弥漫性”和“弥漫性细流状”在基线时显示出较高的PR-RPE丢失比，并且对GA进展斜率有显著统计学贡献（p = 0.01和p = 0.0019）。基线GA病变大小与基线时的PR-RPE丢失比呈负相关（ρ = -0.47，p < 0.0001）。总体而言，基线时PR-RPE丢失比较高的患者GA生长更快（ρ = 0.35，p = 0.0011），并且该比值对GA进展斜率的贡献具有统计学意义（p = 0.0001）。
PR-RPE丢失比较高的眼睛更有可能表现出“弥漫性”和“弥漫性细流状”的FAF模式，并且显示出较高的GA进展率。因此，从FAF和OCT图像得出的基线特征可能提供有关病变进展的信息。
