FRIDAY, Jan. 13, 2023 (HealthDay News) — Two processes seem to contribute to age-related macular degeneration (AMD), according to a study published online Jan. 9 in Eye.

Wei Wei, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues performed spectral-domain optical coherence tomography (SD-OCT) and quantitative autofluorescence (qAF) imaging on the qAF-ready Heidelberg Spectralis in 23 eyes of 18 patients with geographic atrophy (GA). A total of 52 GA regions of interest (ROI) were selected and divided into groups based on the dominant intermediate AMD precursors on prior serial tracked SD-OCT scans.

The researchers identified three groups of lesions: group 1 lesions (soft drusen/pigment epithelial detachments; 18 lesions) had lower mean qAF; group 3 lesions (subretinal drusenoid deposits [SDDs]; 12 lesions) were multilobular and had significantly higher mean qAF; and group 2 lesions (mixed precursors; 22 lesions) had intermediate qAF (35.88 ± 12.75; 71.62 ± 12.12; and 58.13 ± 67.92 units, respectively). In SDD-associated GA, the prevalence of split retinal pigmented epithelium/Bruch’s membrane complex was significantly greater, suggesting that the major structural difference was basal laminar deposit rather than in drusen-associated lesions.

“Combined with our prior research, this provides conclusive evidence that two different disease processes in AMD are taking place, one with darker fluorescence and drusen, and one with brighter fluorescence and SDDs, and they need to be treated differently,” a coauthor said in a statement.

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