Purchase this article with an account.
A.E. Elsner, A.J. Morandi, J.P. Walker, G.L. Wing, P.A. Raskauskas, D.C. Fletcher, A.T. Ghuman, C. Kiesel; Progression in the Longitudinal SW Florida Age-Related Macular Degeneration Study . Invest. Ophthalmol. Vis. Sci. 2003;44(13):5028.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To assess risk factors for visual loss in Age-related Macular Degeneration (AMD), for patient management. To investigate familial, clinical, and imaging risk factors for prognosis, beyond diagnosis. Methods: At study entry, patients had no significant atrophy or exudation in the central macula, best visual acuity at least 20/60, no eye disease other than AMD in the test eye, and no diabetes. The 100 patients, 61 females and 39 males, recruited 1995-1995, were evaluated and retested in 1999-2001. The primary outcome measure is presence of permanent loss of vision of at least a doubling of minimum angle of resolution, clearly associated with exudation. Infra-red and red imaging with a scanning laser ophthalmoscope (SLO) was used to image drusen and focal hyperpigmentation. The severity of focal hyperpigmentation on study entry, by red imaging and indirect mode, was: 0= minimal hyperpigmentation, 1= significant focal hyperpigmentation, and 2=clumped hyperpigmentation. The history included self-report of family history for AMD or glaucoma. Results: Patients reported having a family history for AMD nearly two times more than for glaucoma (p = .00067), but had no more instances of vision loss with exudation (13%), than the patients with family history of glaucoma (13%), or the whole sample (22%). There were no differences in age. Logistic regression on age, family history of AMD, and focal hyperpigmentation grade indicated that only focal hyperpigmentation predicted which patients would lose visual acuity due to exudation (p = .5225, .0990, and .0061). Conclusions: In this sample of patients AMD, there is good predictive power for prognosis, based on an imaging variable, e.g. focal hyperpigmentation, or our previous fellow eye result, but not age or a positive family history. Our results are consistent with familial factors not describing a select group of people who seek eye care sooner or have worse prognosis when several eye or systemic disease variables are exclusion criteria.
This PDF is available to Subscribers Only