Quantitative autofluorescence (qAF8) level is a presumed surrogate marker of lipofuscin content in the retina. We investigated the changes in the qAF8 levels in non-neovascular AMD. In this prospective cohort study, Caucasians aged ≥50 years with varying severity of non-neovascular AMD in at least one eye and Snellen visual acuity ≥6/18 were recruited. The qAF8 levels were analysed in the middle eight segments of the Delori pattern (HEYEX software, Heidelberg, Germany). The AMD categories were graded using both the Beckman classification and multimodal imaging (MMI) to include the presence of subretinal drusenoid deposits (SDD). A total of 353 eyes from 231 participants were analyzed. Compared with the age-matched controls, the qAF8 values decreased in the eyes with AMD (adjusted % difference = −19.7% [95% CI −28.8%, −10.4%]; p < 0.001) and across the AMD categories, (adjusted % differences; Early, −13.1% (−24.4%, −1%), p = 0.04; intermediate AMD (iAMD), −22.9% (−32.3%, −13.1%), p < 0.001; geographic atrophy −25.2% (−38.1%, −10.4%), p = 0.002). On MMI, the qAF8 was reduced in the AMD subgroups relative to the controls, (adjusted % differences; Early, −5.8% (−18.9%, 8.3%); p = 0.40; iAMD, −26.7% (−36.2%, −15.6%); p < 0.001; SDD, −23.7% (−33.6%, −12.2%); p < 0.001; atrophy, −26.7% (−39.3%, −11.3%), p = 0.001). The qAF8 levels declined early in AMD and were not significantly different between the severity levels of non-neovascular AMD, suggesting the early and sustained loss of function of the retinal pigment epithelium in AMD.

This project aimed to address the issue of patients experiencing prolonged fasting periods before undergoing abdominal ultrasound scans in a busy surgical service at our hospital. A review of in-patient data revealed that 78% of patients were not following the recommended 6 hours fast before the scan. This led to poor patient experiences, prolonged diagnosis and management, and increased costs due to rescheduling of scans. To address this problem, a series of plan-do-study-act (PDSA) cycles were implemented to test different interventions aimed at improving staff awareness and compliance with fasting guidelines. The first PDSA cycle involved displaying a poster with fasting instructions in the doctors and nursing offices. This was followed by increasing awareness of guidelines during meetings and presenting the findings at a teaching session. Each PDSA cycle was followed by data collection to assess the impact of the intervention. The project resulted in an improvement in patient experiences, with 88% of patients being appropriately fasted by the end of the project. The study highlights the importance of using PDSA cycles to test and refine interventions and the positive impact of simple interventions on patient outcomes and clinical workflow.