Stargardt Disease - 4-year follow-up of Geographic Atrophy

This is a montage of fundus autofluorescent (FAF) images over time taken from a 71-year-old female patient with Stargardt disease. One can see the progression of the geographic atrophy at several locations over the 4 year follow-up. Retinal pigment epithelial (RPE) atrophy in FAF images appears black. For example, compare the area indicated with the blue arrow in 2014 with the same, larger area indicated by the red arrow in 2015. As another example, look at the area indicated by the green arrow in 2015 and compare the same area indicated by the red arrow in 2018. At the yellow arrows are indicated several of the countless locations with increased autofluorescence (white) corresponding to excessive accumulation of lipofuscin in RPE cells. Hyperautofluorescence corresponding to too much lipofuscin precedes cell death and RPE atrophy. The first two columns of images are blue light FAF images taken with the Heidelberg camera. The rightmost column of images comprises green light FAF images from an OPTOS scanning laser ophthalmoscope. Both modalities (using either blue or green wavelength stimulating radiation) show similar changes.