Objective To compare and quantitatively analyse the different characteristics of multimodal imaging of geographic atrophy (GA) in age-related macular degeneration (AMD). Methods The study included multimodel images of 32 eyes of 27 patients with GA secondary to AMD. There were 14 males (17 eyes) and 13 females (15 eyes). The age ranged from 64 to 83 years, with the mean age of (74.4±7.6) years. All eyes were examined by color fundus photography (CFP), fundus autofluorescence (FAF), fundus fluorescein angiography (FFA) and spectral domain optical coherence tomography (OCT). Using image J software, two trained ophthalmologists, operating in masked fashion, graded the area of lesions of CFP, FAF and FFA independently and compared the sizes of GA area. OCT was performed to confirm the border of lesion when FAF difficult to be determined. The results consistency of two ophthalmologists was analyzed by Bland-Altman. Results The results consistency was high of two ophthalmologists, with the variation range of FFA＜FAF＜CFP. The GA area of CFP, FAF and FFA were (19.81±13.03), (21.50±13.61), (23.10±14.29) mm2. The difference of GA area between three multimodel images was statistically significant (F=0.466, P=0.629). Conclusion The mean size of GA measured by CFP, FAF and FFA showed no statistical difference.
Atrophic age-related macular degeneration (AMD) does not show obvious loss of visual function in the early stage, so it is not easy to be taken seriously. In the advanced stage, most of the patients suffered from macular area retinal map atrophy, which affected night vision and central vision. Drugs currently used in clinical or clinical trials to treat atrophic AMD include drugs for improving choroidal perfusion, reducing the accumulation of harmful substances, preventing oxidative stress injury, inhibiting inflammatory reactions, as well as neuroprotectants and lipid metabolism drugs. Stem cell transplantation for atrophic AMD is currently the most promising treatment. In theory, it is feasible to replace atrophic AMD with retinal photoreceptor cells and RPE cells derived from human stem cell differentiation. However, there are still many problems to be solved, such as how to improve the efficiency of directional differentiation of seed cells and how to ensure the safe and effective RPE cell transplantation and survival after transplantation. At present, several studies have found that multiple locus mutations are associated with atrophic AMD, so gene therapy also plays an important role in the development of the disease.