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A Systematic Review and Meta-Analysis

Shen, Liangbo L. BS*; Liu, Feimei BS; Nardini, Holly Grossetta MLS; Del Priore, Lucian V. MD, PhD*

doi: 10.1097/IAE.0000000000002480

Purpose: To reclassify fundus autofluorescence (FAF) patterns around geographic atrophy (GA) based on GA progression rates.

Methods: MEDLINE, EMBASE, Cochrane Library,, and PubMed were searched for studies reporting GA progression rates among different FAF patterns, such as “None,” “Focal,” “Banded,” “Patchy,” “Diffuse Nontrickling,” and “Diffuse Trickling.” The GA radius growth rate among different FAF patterns was compared, and a GA growth function for each group was derived. To account for the patients' different entry times, a horizontal translation factor was introduced to shift each data subset from “time after enrollment” to “duration of GA.”

Results: Seven studies with 496 eyes were included. Based on GA radius growth rates, the six FAF patterns were clustered into four groups with a high correlation coefficient within each group: Group 1, None, 0.061 mm/year (r2 = 0.996), Group 2, Focal, 0.105 mm/year (r2 = 0.987), Group 3, Banded, Patchy, and Diffuse Nontrickling, 0.149 mm/year (r2 = 0.993), and Group 4, “Diffuse Trickling, 0.245 mm/year (r2 = 0.997).

Conclusion: This meta-analysis suggested that the six FAF patterns can be coalesced into four groups based on lesion progression rates. Simplification of the reclassified FAF patterns may shed light on the GA natural history and assist in the design of clinical trials.

In this meta-analysis, the authors determined the progression rates of geographic atrophy with different fundus autofluorescence patterns. The previously reported six patterns were reclassified into four groups based on the radius growth rate, which is 0.061, 0.105, 0.149, and 0.245 mm/year, respectively.

*Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut;

Department of Biomedical Engineering, Yale University, New Haven, Connecticut; and

Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut.

Reprint requests: Lucian V. Del Priore, MD, PhD, Department of Ophthalmology and Visual Science, Yale University School of Medicine, 40 Temple Street, Suite 1B, New Haven, CT 06510; e-mail:

Supported by the Research to Prevent Blindness (Principal Investigator: Del Priore).

Part of this work was presented at the Association for Research in Vision and Ophthalmology Annual Meeting, Honolulu, HI, April 30, 2018.

None of the authors has any financial/conflicting interests to disclose.

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© 2019 by Ophthalmic Communications Society, Inc.