We evaluated the progression of geographic atrophy (GA) based on fundus autofluorescence (FAF) pattern and atrophy size using the fundus camera in non-exudative age-related macular degeneration (ARMD).

We acquired FAF images in non-exudative ARMD patients over a 2-year period. According to The Fundus Autofluorescence in Age-related Macular Degeneration (FAM) study, FAF patterns of geographic atrophy were classified into 5 categories. Examiners quantified the areas of GA in FAF images and analyzed the progression of atrophy based on FAF pattern and atrophy size.

In 86 non-exudative ARMD eyes, elderly patients had faster progression rate of GA. The growth rates of GA were 1.51 mm²/year in 'Diffuse', 1.49 mm²/year in 'Banded', 1.05 mm²/year in 'Patchy', 0.59 mm²/year in 'Focal' and 0.16 mm²/year in 'None' pattern groups. In addition, the growth rate was 0.38 mm²/year in which initial the GA area was smaller than 1 disc area. This was the slowest progression rate among all categories according to initial GA area.

As a result of evaluating the progression of geographic atrophy using FAF over a 2-year period, the growth rate of GA was the fastest in the 'Diffuse' pattern group. Additionally, as the initial GA area became smaller, the progression of GA atrophy was slower ( p < 0.002). Although limitations such as short follow-up period and measurement error of GA atrophy area using fundus photography were compensated, the results in the present study were similar to the outcomes of studies on progression of GA based on FAF pattern using the scanning laser ophthalmoscope over several years and the fundus camera for 1 year. In conclusion, the fundus camera is a useful tool for the prediction of long-term progression of GA in patients with non-exudative ARMD.