Fig. 8.3 Fundus photographs of the right (a) and left (b) eye in a patient with dry AMD shows deposition of variably sized drusen in the perifoveal and temporal paramacular region. Note that there is evidence of early RPE alterations and atrophy. Fundus AF of the right (c) and left

(d) eyes shows that there is a large area of well-defined central GA in both eyes. There is a faint, irregular rim of hyperfluorescence along the margins of the GA at the border of preserved and attenuated RPE

Pearl

FAF is a noninvasive measure of lipofuscin distribution and RPE integrity throughout the fundus. FAF can be utilized to monitor progression of patients with dry AMD. OCT is a noninvasive imaging modality that can be used to sequentially monitor the response to therapy. Fourier domain/spectral domain OCT provides greater image resolution and can be used to assess drusen volume using segmentation software.

Although there is no proven Food and Drug Administration (FDA)-approved drug treatment for GA, smoking cessation [15] and treatment based on oral supplements as outlined in the AgeRelated Eye Disease Study (AREDS) trial [16] may slow the disease progression. Numerous therapeutic strategies have been postulated with three main endpoints: preservation of photoreceptors and RPE (neuroprotection), prevention of oxidative damage, and suppression of inflammation. The most important endpoint to assess efficacy for dry AMD is obviously the preservation of visual