Name

Caractérisation de l'atrophie géographique en imagerie rétromode

Purpose: To compare retromode scanning laser ophthalmoscopy (SLO) images versus pseudocolor fundus photographs and fundus autofluorescence images in evaluation of area and patterns of atrophic age-related macular degeneration.

Design: Retrospective, observational study.

Participants: 50 patients (32 men and 18 women; mean age, 82.3±10 years) with atrophic non-neovascular age-related macular degeneration were included.

Methods: All participants underwent multimodal imaging assessment with a confocal scanning laser ophthalmoscope, including pseudo-color photographs, green fundus autofluorescence, and retromode imaging deviated to the right and left. For each modality, the area under the receiver operating characteristic curve was calculated to evaluate the capability to identify geographic atrophy. The area of atrophy was measured by two independent graders for each multimodal imaging modalities. The intraclass correlation coefficient and intergrader correlation coefficient were assessed. Using retromode imaging, patterns of geographic atrophy were characterized according to the atrophic area, junctional zone and presence of additional lesions.

Main Outcome Measures: Agreement between retromode imaging, pseudocolor fundus photography and fundus autofluorescence in quantification of geographic atrophy.

Results: A total of 50 eyes were evaluated. The inter-rate reliability between graders for each imaging modality ranged from 0.75 to 0.96. The weighted k values in reproducibility analysis for retromode imaging, pseudocolor fundus photography and fundus autofluorescence were 0.78, 0.80, and 0.85, respectively. No significant difference were found regarding the area under the receiver operating characteristic curve between each imaging modality. Using retromode imaging, geographic atrophy exhibited a distinctive phenotype reminiscent of a meteorite crater-like appearance with central smooth area corresponding to geographic atrophy and peripheral pseudo-elevated rim colocalizing with the junctional zone. Surrounding small drusen were better detected with the retromode imaging.

Conclusions and Discussion: Retromode imaging demonstrated excellent potential to characterize geographic atrophy and was in agreement with conventional methods to measure the lesion area.

Conclusions and Discussion: Retromode imaging demonstrated excellent potential to characterize geographic atrophy and was in agreement with conventional methods to measure the lesion area.