gms | German Medical Science

22nd Annual Meeting of the German Retina Society

German Retina Society

26.06. - 27.06.2009, Berlin

Imaging Geographic Atrophy Progression by High resolution Spectral Domain OCT in Patients with Age-related Macular Degeneration

Meeting Abstract

  • Monica Fleckenstein - University Eye Clinic of Bonn
  • S. Schmitz-Valckenberg - University Eye Clinic of Bonn
  • I. Krämer - University Eye Clinic of Bonn
  • R. P. Finger - University Eye Clinic of Bonn
  • H. M. Helb - University Eye Clinic of Bonn
  • P. Charbel Issa - University Eye Clinic of Bonn
  • C. H. Meyer - University Eye Clinic of Bonn
  • F. G. Holz - University Eye Clinic of Bonn

German Retina Society. 22nd Annual Meeting of the German Retina Society. Berlin, 26.-27.06.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocRG2009-48

doi: 10.3205/09rg49, urn:nbn:de:0183-09rg496

This is the translated version of the article.
The original version can be found at:

Published: June 29, 2009

© 2009 Fleckenstein et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Purpose: To investigate microstructural alterations in a prospective longitudinal study (FAM study, Identifier: NCT00393692) in eyes with geographic atrophy (GA) due to age-related macular degeneration (AMD) by spectral domain (SD) optical coherence tomography (OCT).

Methods: Twenty-eight eyes of 15 patients (mean age 77.9 ± 5.5 years) with GA had serial examination with a mean follow-up period so far of 10.8 months ± 3.8 months by simultaneous confocal scanning laser ophthalmoscopy and SD-OCT imaging (Spectralis® HRA+OCT, Heidelberg Engineering, Germany). Real-time registration of eye movements allowed for alignment of follow-up to baseline scans and therefore subsequent accurate three-dimensional analysis of structural alterations over time. Longitudinal SD-OCT images were analyzed and microstructural changes within the atrophic lesions, at the border and in the perilesional zone of GA were evaluated.

Results: In all eyes, GA showed marked enlargement within the cSLO images. GA progression or evolution was associated with advancing loss of the retinal pigment epithelium (RPE)- and the inner and outer segments of the photoreceptor layer (IPRL) with subsequent disappearance of the external limiting membrane. The outer nuclear layer progressively collapsed within the atrophic lesion. Areas preceding atrophy displayed an irregular RPE- layer and IPRL. The borders of GA hereby showed differential progression. Within the atrophic lesion and in the perilesional zone, migration of hyperreflective material was noted, and both, increase in drusen volume as well as drusen fading occurred at different regions.

Conclusions: Recent developments in retinal imaging technologies allow for high resolution imaging of dynamic morphological alterations in retinal diseases. In eyes with GA, marked changes within the atrophic lesion, at the border and in the perilesional zone of GA can be visualized over a relatively short time period. The study will be continued and will provide further understanding of the natural history of GA progression. This information may also be useful in monitoring future therapeutical interventions aiming at slowing GA enlargement.