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Vesna Jurisic Friberg, Goran Bencic, Mia Zoric-Geber, Biljana Andrijevic Derk, Tamara Knezević, Zoran Vatavuk, Thomas R Friberg; Morphologic Changes in the Retinal Periphery in Patients with Age-Related Macular Disease and Controls.The Croatian OPERA (Optos PERipheral RetinA) Study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2998.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the morphologic and fluorescein angiographic peripheral retinal changes in subjects with age related macular disease using a wide field fundus camera, Optomap P200 MA, and to compare the results to those from age-matched controls. Subjects: 150 with signs of AMD (AMD Group) and 150 subjects without signs of AMD in the macula (Control Group). All were Caucasian and older than 50 years.
Fundus images were obtained by a wide field system (Optomap P200 MA) and were read after superimposing a special grid on each fundus image. Only those of good quality and a minimum of 270 degrees of the periphery included in the fields were included. Subjects with confounding diseases such as diabetic retinopathy were excluded. Angiography was performed in AMD subjects. Morphologic and angiographic changes including drusen (D), reticular pigmentary changes (RPC), hypo and hyper-pigmentation, neovascularization and other degenerative changes were recorded according to type, frequency of occurrence, clock hours of affected peripheral retina and location with respect to the to equator. Statistical significance was reached when p < 0.05.
Drusen, reticular pigmentary changes, and paving stone degeneration occurred more frequently in the AMD group with a statistically significant difference D z=10,13, RPC z= 9,9083, Paving Stone z=5,756. Drusen were present in 68% of eyes in subjects with AMD and located pre-equatorially in 46%. In the control group, any drusen were seen in 25% eyes and located pre-equatorially in 49% of those. On angiography, we found that the median number of clock-hours of the retinal periphery affected with drusen was significantly higher in dry as opposed to wet amd eyes. Reticular pigmentary changes were observed in 41% eyes of AMD group and in only 8% of control subject eyes.These changes were more easily seen on angiography but were present in both color and angiographic images. In the AMD group, paving stone degeneration was seen in 18% eyes compared to 3% of control eyes.Other hyper-pigmented and hypo-pigmented lesions were present with equal frequency in AMD and control eyes.
Reticular pigmentary changes and paving stone degeneration occur significantly more frequently eyes in AMD eyes than control eyes. The prevalence of peripheral drusen was higher in dry AMD eyes as opposed to wet amd eyes.
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