Abstract
Purpose:
Our understanding of the relevance of peripheral pathologies in general and in Age Related Macular Degeneration (AMD) in particular is limited by the lack of detailed peripheral imaging studies.The purpose of this study was to investigate potention relationships between macular and peripheral pathologies with genetic variation in an aged population.
Methods:
This is a cross-sectional study of a random population sample as part of the 12 year follow-up of the Reykjavik Eye Study in Iceland. Ultra wide field (up to 200°) color and autofluorescence (AF) images were taken of 573 subjects aged 62 years or older using the Optos P200C AF laser scanning ophthalmoscope. Macular and peripheral changes were graded using a grid developed for this imaging modality. Presence or absence of hard, crystalline and soft drusen, retinal pigment epithelial changes, choroidal neovascularisation and atrophy and hypo-and hyperfluorescence were graded of the peripheral retina and these were correlated with genetic variation.
Results:
18.9% of the eyes examined were free of pathologies both in the macula and the periphery. There were eyes with pathology only in the macula (13.6%) or only in the periphery (10.1%) while pathologies at both locations were the most frequent (57.4%), with the majority of pathologies being in the far periphery (zone 5). No patient with end-stage disease in the macula had normal periphery. The genetic analysis confirmed previously reported associations between high risk macular phenotypes with rs10737680 and rs10490924 polymorphisms OR = 2.17 (P = 0.032) and 3.25 (P = 0.00010). No genetic association was found for peripheral phenotypes in this population.
Conclusions:
Phenotyping retinal periphery confirmed the presence of wide ranging sub-RPE deposit formation in the periphery even in those without central sight threatening disease. There was no genotypic association with peripheral retinal changes in our samples.
Keywords: 550 imaging/image analysis: clinical •
412 age-related macular degeneration •
504 drusen