Background: As members of the Fundus Autofluorescence in Age-related Macular Degeneration Study Group (FAM Study Group), we report changes of fundus autofluo rescence (AF)-in patients with multiple soft drusen in correlation to visual fu nction. Methods: Inclusion criteria were age > 50 years, the presence of soft dr usen, visual acuity of 20/100 or better, and no previous laser treatment in the study eye. All patients underwent a detailed ophthalmological examination includ ing ETDRS visual acuity, binocular funduscopy, and color fundus photography. AF imaging was performed with a confocal scanning laser ophthalmoscope following a standard protocol. We used the classification of the International Fundus Auto- fluorescence Classification Group (IFAG) for the description of the AF patterns. Results: One hundred and twenty-five patients (81 women, 44 men) aged from 55 to 86 years (mean 70±7 years) were included in this prospective study. During f ollow-up (mean 18±6 months), 6 of 35 eyes with patchy AF pattern developed exu dative changes, as well as 2 eyes with focal-plaque-like AF pattern and 1 eye with reticular pattern at baseline. Geographic atrophy was seen in two eyes with focal AF pattern and one eye with focal-plaque-like pattern at baseline. A to tal of 11 eyes presented with severe visual loss (6 ETDRS lines). Ten (91%) o f these had patchy AF pattern. Conclusion: Imaging of fundus AF in patients with age-related maculopathy allows identification of different patterns of fundus AF. Our preliminary data suggest that a patchy pattern of AF indicates a relativ ely high risk of progression to age-related macular degenerationwith visual los s. Background: As members of the Fundus Autofluorescence in Age-related Macular Degeneration Study Group (FAM Study Group), we report changes of fundus autofluo rescence (AF) -in patients with multiple soft drusen in correlation to visual fuction. Methods: Inclusion criteria were age> 50 years, the presence of soft dr usen, visual acuity of 20/100 or better, and no previous laser treatment in the study eye. All patients underwent a detailed ophthalmological examination includ ETDRS visual acuity, binocular funduscopy, and color fundus photography. AF imaging was performed with a confocal scanning laser ophthalmoscope following a standard protocol. We used the classification of the International Fundus Auto-fluorescence Classification Group (IFAG) for the description of the AF patterns. Results: One hundred and twenty-five During the period from 55 to 86 years (mean 70 ± 7 years) were included in this prospective study. During f ollow-up (mean 18 ± 6 months), 6 of 35 ey es with patchy AF pattern developed exu dative changes, as well as 2 eyes with focal-plaque-like AF pattern and 1 eye with reticular pattern at baseline. Geographic atrophy was seen in two eyes with focal AF pattern and one eye with focal-plaque -like pattern at baseline. A to tal of 11 eyes presented with severe visual loss (6 ETDRS lines). Ten (91%) of these had patchy AF pattern. Conclusion: Imaging of fundus AF in patients with age-related maculopathy identification of different patterns of fundus AF. Our preliminary data suggest that a patchy pattern of AF indicates a relativ ely high risk of progression to age-related macular degeneration with visual los s.