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A longitudinal study of Stargardt disease: quantitative assessment of fundus autofluorescence, progression, and genotype correlations
Journal article   Open access   Peer reviewed

A longitudinal study of Stargardt disease: quantitative assessment of fundus autofluorescence, progression, and genotype correlations

Kaoru Fujinami, Noemi Lois, Rajarshi Mukherjee, Vikki A McBain, Kazushige Tsunoda, Kazuo Tsubota, Edwin M Stone, Fred W Fitzke, Catey Bunce, Anthony T Moore, …
Investigative ophthalmology & visual science, Vol.54(13), pp.8181-8190
12/17/2013
DOI: 10.1167/iovs.13-12104
PMID: 24265018
url
https://kclpure.kcl.ac.uk/portal/en/publications/18d9c19e-4a3a-435c-b7b6-7058f331b013View
Open Access

Abstract

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.
Mutation Follow-Up Studies Humans Middle Aged Child, Preschool Male Macular Degeneration - diagnosis Young Adult Retinal Pigment Epithelium - pathology ATP-Binding Cassette Transporters - genetics DNA Mutational Analysis ATP-Binding Cassette Transporters - metabolism Adult Female Child Electroretinography Fluorescein Angiography - methods Ophthalmoscopy Genotype Disease Progression DNA - genetics Macular Degeneration - metabolism Macular Degeneration - congenital Macular Degeneration - genetics Adolescent Aged Fundus Oculi

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