September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Peripheral Retinal Abnormalities Associated with Age-Related Macular Degeneration in the Age-Related Eye Diseases Study 2 (AREDS2)
Author Affiliations & Notes
  • Thomas R Friberg
    Ophthalmology and BioEngineering, Univ of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Amitha Domalpally
    Reading Center, Univ of Wisconsin, Madison, Wisconsin, United States
  • Ron Danis
    Reading Center, Univ of Wisconsin, Madison, Wisconsin, United States
  • Traci E Clemons
    Emmes Corporation, Bethesda, Maryland, United States
  • Srinivas R Sadda
    Doheny, Los Angeles, California, United States
  • Cynthia A Toth
    Duke Eye Center, Durham, North Carolina, United States
  • Emily Y Chew
    National Eye Institute, Bethesda, Maryland, United States
  • Footnotes
    Commercial Relationships   Thomas Friberg, Optos (C); Amitha Domalpally, None; Ron Danis, None; Traci Clemons, None; Srinivas Sadda, None; Cynthia Toth, None; Emily Chew, None
  • Footnotes
    Support  Optos, NEI
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Thomas R Friberg, Amitha Domalpally, Ron Danis, Traci E Clemons, Srinivas R Sadda, Cynthia A Toth, Emily Y Chew; Peripheral Retinal Abnormalities Associated with Age-Related Macular Degeneration in the Age-Related Eye Diseases Study 2 (AREDS2). Invest. Ophthalmol. Vis. Sci. 201657(12):.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : Purpose: Although age-related macular degeneration (AMD) is considered a macular disease, researchers have detected peripheral retinal abnormalities in autopsy eyes. Others have suggested that this is a disease of the retinal pigment epithelium (RPE) throughout the entire retina. The purpose of this study is to assess the association of peripheral retinal abnormalities in AMD.

Methods : A subset of AREDS2 participants, who had late AMD or intermediate AMD (bilateral large drusen), were enrolled in a study of ultra-widefield (up to 200 degrees) color and fundus autofluorescence imaging using the Optos 200Tx laser scanning ophthalmoscope (Optos plc) at study close-out. An age-matched comparator group enriched with participants without AMD were also imaged. Images were graded at a reading center with a standard grid of 3 zones on the entire retina. Peripheral lesions were compared among the two groups.

Results : Of the 575 enrolled, 484 (951 eyes) of the AREDS2 participants and 183 (347 eyes) of controls had gradable images at least in zone 1 (or the posterior pole) images. Among the AREDS2 participants, all had large drusen, 30% had neovascular (NV) AMD and 26% had geographic atrophy (GA) in the posterior pole (zone 1). In the comparator group, 47% had large drusen, 31 eyes had advanced AMD. Additional NV and GA could be detected peripherally: in zone 2 (covering the midperipheral retina) 5% and 6%, in AREDS2 and comparator groups respectively, and in zone 3 (midperiphery to the ora serrata) 0.8% and 6%, respectively. The following peripheral abnormalities were found in AREDS2 versus comparator group for zone 2: large drusen 97% vs. 62%, pseudoreticular drusen 15% vs. 3%, hyperpigmentation 46% vs.18%, and hypopigmentation 27% vs. 1%, respectively. Other common peripheral abnormalities the superior zone 3: cobblestone 18% vs. 19%, and reticular pigmentary changes: 62% vs. 43% respectively.

Conclusions : Preliminary analysis of these groups suggests persons with AMD have a markedly higher risk of having peripheral large drusen, hypo/hyperpigmentation, and reticular pseudodrusen. Peripheral abnormalities in aggregate also occurred more commonly in AREDS eyes. These data demonstrate that AMD is indeed a pan-retinal disease, accounting for some of the functional changes that occur early in AMD. Examination of the retinal periphery may be important in persons with AMD.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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