gms | German Medical Science

25th Annual Meeting of the German Retina Society

German Retina Society

01.06. - 02.06.2012, Münster

Imaging of focally increased pigment in early and Intermediate AMD – analysis of longitudinal alterations

Meeting Abstract

  • Arno P. Göbel - Universitäts-Augenklinik Bonn
  • S. Grundei - Universitäts-Augenklinik Bonn
  • F.G. Holz - Universitäts-Augenklinik Bonn
  • S. Schmitz-Valckenberg - Universitäts-Augenklinik Bonn

German Retina Society. 25th Annual Conference of the German Retina Society. Münster, 01.-02.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12rg33

DOI: 10.3205/12rg33, URN: urn:nbn:de:0183-12rg338

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

Published: May 30, 2012

© 2012 Göbel 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: Focally increased pigment represents a high-risk factor for AMD progression. Purpose of the study was to determine alterations of increased pigment in early and intermediate AMD by means of multimodal imaging over time.

Methods: 18 eyes with early or intermediate AMD (AREDS-classification) of 14 patients (mean age 74) were included. Imaging including color fundus photography (CFP) (Visucam), cSLO-fundus autofluorescene (FAF) and spectral-domain optical coherence tomography (SD-OCT) (Spectralis HRA+OCT) was performed at baseline examination (t0) and one year later (t1). After semi-automated alignment of different imaging modalities and examination dates, each increased pigment was topographically correlated with the focal FAF- and SD-OCT-signal.

Results: Increased pigment was funduscopically visible in 8 of 18 eyes at t0 and t1. At t1, 27 loci of increased pigment were identified, of which 11 showed an increase, 5 a decrease and 11 no change in size over time. FAF at t0 revealed an increased signal in 14 and a normal signal in 6 cases. FAF signal altered over time in 3 cases: from increased at t0 to normal at t1. SD-OCT imaging showed focal hyperreflectivity above band 4 in 8 and only at band 4 level in 2 cases. At 4 sites of increased pigment SD-OCT revealed migration of the hyperreflective signal in inner retinal direction.

Conclusion: Increased pigment visible in CFP correlates with different alterations in FAF and SD-OCT. By means of multimodal imaging dynamic change over time alluding to migration of RPE cells and compromised outer retinal integrity can be identified.