TY - JOUR
T1 - A longitudinal study of Stargardt disease
T2 - quantitative assessment of fundus autofluorescence, progression, and genotype correlations.
AU - Fujinami, Kaoru
AU - Lois, Noemi
AU - Mukherjee, Rajarshi
AU - McBain, Vikki A.
AU - Tsunoda, Kazushige
AU - Tsubota, Kazuo
AU - Stone, Edwin M.
AU - Fitzke, Fred W.
AU - Bunce, Catey
AU - Moore, Anthony T.
AU - Webster, Andrew R.
AU - Michaelides, Michel
PY - 2013/12
Y1 - 2013/12
N2 - We characterized subtypes of fundus autofluorescence (AF) and the progression of retinal atrophy, and correlated these findings with genotype in Stargardt disease. Full clinical examination and AF imaging was undertaken in 68 patients with Stargardt disease. The baseline data were compared to those at follow-up. Patients were classified into three AF subtypes: type 1 had a localized low signal at the fovea surrounded by a homogeneous background, type 2 had a localized low signal at the macula surrounded by a heterogeneous background with numerous foci of abnormal signal, and type 3 had multiple low signal areas at the posterior pole with a heterogeneous background. At baseline, there were 19 patients with type 1, 41 with type 2, and 8 with type 3 disease. The areas of reduced AF signal were measured and rate of atrophy enlargement (RAE) was calculated as the difference of the atrophy size over time (mm2) divided by the follow-up interval (years). Molecular screening of ABCA4 was undertaken. The mean follow-up interval was 9.1 years. A total of 42% cases with type 1 disease progressed to type 2, and 12% with type 2 progressed to type 3. The RAE (mm2/y) based upon baseline AF subtypes was significantly different; 0.06 in type 1, 0.67 in type 2, and 4.37 in type 3. ABCA4 variants were identified in 57 patients. There was a significant association between AF subtype and genotype. The AF pattern at baseline influences the enlargement of atrophy over time and has genetic correlates. These data are likely to assist in the provision of counseling on prognosis in Stargardt disease and be valuable for future clinical trials.
AB - We characterized subtypes of fundus autofluorescence (AF) and the progression of retinal atrophy, and correlated these findings with genotype in Stargardt disease. Full clinical examination and AF imaging was undertaken in 68 patients with Stargardt disease. The baseline data were compared to those at follow-up. Patients were classified into three AF subtypes: type 1 had a localized low signal at the fovea surrounded by a homogeneous background, type 2 had a localized low signal at the macula surrounded by a heterogeneous background with numerous foci of abnormal signal, and type 3 had multiple low signal areas at the posterior pole with a heterogeneous background. At baseline, there were 19 patients with type 1, 41 with type 2, and 8 with type 3 disease. The areas of reduced AF signal were measured and rate of atrophy enlargement (RAE) was calculated as the difference of the atrophy size over time (mm2) divided by the follow-up interval (years). Molecular screening of ABCA4 was undertaken. The mean follow-up interval was 9.1 years. A total of 42% cases with type 1 disease progressed to type 2, and 12% with type 2 progressed to type 3. The RAE (mm2/y) based upon baseline AF subtypes was significantly different; 0.06 in type 1, 0.67 in type 2, and 4.37 in type 3. ABCA4 variants were identified in 57 patients. There was a significant association between AF subtype and genotype. The AF pattern at baseline influences the enlargement of atrophy over time and has genetic correlates. These data are likely to assist in the provision of counseling on prognosis in Stargardt disease and be valuable for future clinical trials.
UR - http://www.scopus.com/inward/record.url?scp=84894541201&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84894541201&partnerID=8YFLogxK
U2 - 10.1167/iovs.13-12104
DO - 10.1167/iovs.13-12104
M3 - Article
C2 - 24265018
AN - SCOPUS:84894541201
SN - 0146-0404
VL - 54
SP - 8181
EP - 8190
JO - Investigative ophthalmology & visual science
JF - Investigative ophthalmology & visual science
IS - 13
ER -