OPERA (Optos Peripheral Retina AMD) Study Croatia: Reticular pigmentation in AMD vs. controls

Abstract

 

Purpose

 

The presence of peripheral reticular pigmentation (PREP) in the retina has been linked to AMD, and may be a phenotypic expression of genes related to the development of AMD. While clinical examination with indirect ophthalmoscopy can reveal such changes, documentation of PREP then becomes rather subjective. Rigorous studies using retinal imaging to document PREP in AMD and control subjects have not been published to our knowledge. We also wished to study AMD patients using both widefield fluorescein angiography (WFFA) and color images.

 

Methods

 

After obtaining IRB approval, 150 subjects with AMD were imaged with the P200A Optos unit and both color fundus images and fluorescein angiographic images were obtained in both eyes. AMD was defined according the guidelines from the International ARM (Age-related maculopathy) Study Group.150 age-matched controls without ARM were also imaged in a similar fashion but without WFFA. Eye steering allowed imaging of the maximum area of the peripheral retina. Masked readers determined the presence or absence of reticular pigmentation in color and fluorescein images, and determined the number of quadrants of pigmentation in each eye. Other morphological parameters were also studied including drusen, paving stone degeneration, white-without pressure, and lattice degeneration.The study was conducted in Zagreb, Croatia, on Caucasian subjects. DNA was collected from all subjects by drawing whole blood.

 

Results

 

For subjects with AMD, reticular pigment was found in 40.65% of the color images and in 46.25% of the fluorescein images. In control subjects, reticular pigment was seen on color images in 8.16% of the eyes. The difference between control and AMD subjects with respect to prevalence of reticular pigment in color images was significant (P<0.03). PREP was more easily seen on fluorescein angiograms than on color images.

 

Conclusions

 

Peripheral reticular pigmentation is much more likely to be present in patients with AMD than controls in our Croatian study population.These findings should be compared to the results from other ethnic groups who suffer from AMD, but are consistent with reports based on clinical fundus examination alone.The genotypes of our subjects will provide further insight into the association of PREP and AMD. Comparisons of results from the OPERA study U.S.(AREDS II ancillary study) to our OPERA: Croatia results will be conducted in 2013.

 

Keywords: 412 age-related macular degeneration • 550 imaging/image analysis: clinical • 701 retinal pigment epithelium