Impact of ocular and systemic risk factors on progression of geographic atrophy in age-related macular degeneration

Background: Geographic atrophy (GA) corresponds to an end-stage form of age-related macular degeneration and the leading cause of irreversible vision loss. The aim of this study was to investigate the role of fundus autofluorescence (FAF) patterns surrounding GA, baseline GA size, the presence of reticular pseudodrusen (RPD), the condition of the fellow eye and the presence of systemic vascular diseases (diabetes, atherosclerosis, systemic hypertension) on the progression of GA due to age-related macular degeneration. Methods: Seventy-five eyes of 52 patients with GA were included into this retrospective study. Digital FAF images were achieved using scanning laser ophthalmoscopy. Areas of GA were measured with the Region Finder software program on an Heidelberg Retinal Angiograph 2. FAF patterns around GA were classified and the presence of RPD and systemic diseases were noted. The median follow-up of the patients was 2.6 years (interquartile range, 1-9.2). Results: The median progression rate of the banded pattern (median 0.97 mm(2)/year) was significantly higher than the other patterns (median 0.85 mm(2)/year) (p = 0.03). Eyes with RPD had a significantly higher progression rate (median 1.21 mm(2)/year) than those without RPD (median 0.79 mm(2)/year) (p = 0.007). The presence of systemic diseases was not related with lesion progression rates. Conclusions: The results demonstrate that the banded pattern and the presence of RPD accelerate the progression of GA and function as predictive factors.