Investigative ophthalmology & visual science · 2026
Directional Association Between Perilesional Fundus Autofluorescence and Geographic Atrophy Border Expansion.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Chujo Shinichiro, Quarta Alberto, Abbasgholizadeh Rouzbeh, Alhelaly Mai, Nittala Muneeswar Gupta, Chung Yu-Chien, Kwak Hyunduck, Soylu Ceren, Rattu Raiyna, Huang Jianfeng, Corradetti Giulia, Velaga Swetha, Forte Paolo, Uji Akihito, Sadda SriniVas R
Аннотация
PURPOSE: The purpose of this study was to evaluate the directional association between perilesional fundus autofluorescence (FAF) intensity and geographic atrophy (GA) border expansion.
METHODS: This study included 102 untreated fellow eyes from the MAHALO clinical trial with FAF images at baseline and 6 months. FAF intensity was normalized within each eye and analyzed within two perilesional zones (0-250 µm and 0-500 µm). The highest and lowest 25% of normalized intensity were defined as hyperautofluorescence (hyperAF) and hypoautofluorescence (hypoAF), respectively. A relative density metric (sector value minus eye-level mean) was calculated for each clock-hour sector. GA border expansion was quantified using Euclidean distance mapping. Associations between FAF density and sector-wise GA expansion were assessed using linear mixed-effects models. Sensitivity analyses using 20% and 30% thresholds and subgroup analysis of unifocal lesions were performed.
RESULTS: Across all conditions, higher hyperAF density was not associated with greater extent of GA border expansion and showed consistently negative regression slopes (all P < 0.001). In contrast, higher hypoAF density was significantly associated with greater GA expansion, with uniformly positive regression slopes across all ring sizes and thresholds (all P < 0.001). These findings were consistent in eyes with unifocal lesions and across sensitivity analyses.
CONCLUSIONS: GA expansion is not preferentially directed toward regions of higher hyperAF but rather, is associated with hypoAF-dominant areas. These findings suggest that GA progression may be related to spatial changes in perilesional autofluorescence (AF) patterns, although the underlying biological mechanisms require further investigation.
METHODS: This study included 102 untreated fellow eyes from the MAHALO clinical trial with FAF images at baseline and 6 months. FAF intensity was normalized within each eye and analyzed within two perilesional zones (0-250 µm and 0-500 µm). The highest and lowest 25% of normalized intensity were defined as hyperautofluorescence (hyperAF) and hypoautofluorescence (hypoAF), respectively. A relative density metric (sector value minus eye-level mean) was calculated for each clock-hour sector. GA border expansion was quantified using Euclidean distance mapping. Associations between FAF density and sector-wise GA expansion were assessed using linear mixed-effects models. Sensitivity analyses using 20% and 30% thresholds and subgroup analysis of unifocal lesions were performed.
RESULTS: Across all conditions, higher hyperAF density was not associated with greater extent of GA border expansion and showed consistently negative regression slopes (all P < 0.001). In contrast, higher hypoAF density was significantly associated with greater GA expansion, with uniformly positive regression slopes across all ring sizes and thresholds (all P < 0.001). These findings were consistent in eyes with unifocal lesions and across sensitivity analyses.
CONCLUSIONS: GA expansion is not preferentially directed toward regions of higher hyperAF but rather, is associated with hypoAF-dominant areas. These findings suggest that GA progression may be related to spatial changes in perilesional autofluorescence (AF) patterns, although the underlying biological mechanisms require further investigation.