Geographic Atrophy and Peripheral Atrophy: Quantitative Analysis with Ultra-Widefield Autofluorescence

To analyze and correlate the topographic distribution of atrophic areas at the posterior pole and peripheral retina in subjects with geographic atrophy (GA) using ultra-widefield fundus autofluorescence (FAF) imaging.

This multicenter observational study included 15 patients (9 males, 19 eyes) with coexisting GA and peripheral atrophy. All eyes were imaged with Ultra-widefield Optos California (Optos, PLC, Dunfermline, Scotland) to acquire ultra-widefield (200°) color and FAF images centered on the fovea, superior, inferior, nasal, and temporal sectors. The extent of GA in the central FAF image and the peripheral atrophic areas in the peripheral FAF images were measured by manually defining the boundaries of the atrophic regions using the "ROI free" function integrated into the device software. The values obtained were then analyzed and correlated.

The mean ± standard deviation (SD) GA size was 13.9 ± 15.0 mm2 (range: 1.8-71.3 mm2) and the total peripheral atrophy was 51.0 ± 68.3 mm2 (range: 1.4-292.1 mm2). The topographic analysis showed that the mean ± SD of superior peripheral atrophy was 9.0 ± 20.6 mm2, temporal atrophy was 30.5 ± 55.9 mm2, inferior atrophy was 9.3 ± 16.3 mm2, and nasal atrophy was 1.8 ± 3.9 mm2. GA size was significantly correlated with total peripheral atrophy (Rho = 0.463, p = 0.046) and temporal peripheral atrophy (Rho = 0.474, p = 0.040), whereas no correlations were found with peripheral atrophy in the remaining sectors.

Ultra-widefield autofluorescence is a valuable technique for visualizing and assessing the extent of macular and peripheral atrophy. Macular atrophy correlates significantly with total and temporal peripheral atrophy but demonstrates no significant correlation with atrophy in the remaining sectors.