New research suggests AMD phenotyping may help reveal the risk of subsequent geographic atrophy (GA) progression, highlighting the potential role of structural AMD features across different disease stages.

The study included 39 eyes with GA of 34 patients who were a mean age of 74.4±6.7 years old. A team used fundus autofluorescence imaging to retrospectively identify structural precursor lesions in atrophic areas that were at least 0.5mm² in size. They then evaluated the lesions for their association with subsequent GA enlargement rates.

The researchers observed five precursor lesions (phenotypes one through five) that preceded GA development: large, subretinal pigment epithelial drusen, reticular pseudodrusen, refractile deposits, pigment epithelial detachment and vitelliform lesions. They noted that these lesions were significantly associated with GA progression, with reticular pseudodrusen (phenotype two) having the fastest enlargement rate of 2.29±0.52mm/year.

Characterizing such imaging features that prove to be prognostically relevant for AMD progression “may facilitate mapping of an underlying long-lasting and ‘constant’ risk profile in patients with AMD,” the study authors concluded in their paper.

Thiele S, Nadal J, Pfau M, et al. Prognostic value of intermediate age-related macular degeneration phenotypes for geographic atrophy progression. Br J Ophthalmol. April 8, 2020. [Epub ahead of print].