June 2015
Volume 56, Issue 7
ARVO Annual Meeting Abstract  |   June 2015
The Croatian Opera Study II: Further study of the peripheral retinal features in AMD subjects and controls
Author Affiliations & Notes
  • Vesna Jurisic Friberg
    Ophthalmology, Mercy Hospital, Zagreb, Croatia
  • Biljana Andrijevevic Derk
    Ophthalmology, Mercy Hospital, Zagreb, Croatia
  • Thomas R Friberg
    Ophthalmology/UPMC Eye Center, UPMC Medical Center, Pittsburgh, PA
  • Tamara Knezevic
    Ophthalmology, Polyclinic Ghetaldus, Zagreb, Croatia
  • Goran Bencic
    Ophthalmology, Mercy Hospital, Zagreb, Croatia
  • Mia Zorich Geber
    Ophthalmology, Mercy Hospital, Zagreb, Croatia
  • Zoran Vatavuk
    Ophthalmology, Mercy Hospital, Zagreb, Croatia
  • Footnotes
    Commercial Relationships Vesna Jurisic Friberg, None; Biljana Andrijevevic Derk, None; Thomas Friberg, optos (C), optos (F); Tamara Knezevic, None; Goran Bencic, None; Mia Zorich Geber, None; Zoran Vatavuk, Optos (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 824. doi:
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      Vesna Jurisic Friberg, Biljana Andrijevevic Derk, Thomas R Friberg, Tamara Knezevic, Goran Bencic, Mia Zorich Geber, Zoran Vatavuk, Opera Croatia; The Croatian Opera Study II: Further study of the peripheral retinal features in AMD subjects and controls. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):824.

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      © ARVO (1962-2015); The Authors (2016-present)

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To study peripheral retinal fluorsecein angiographic and color photographic findings in AMD subjects and controls using ultra-wide angle imaging


In Croatia, 150 patients with posterior AMD and 150 age matched controls were imaged with the Optos P200 MA device. Fluorescein angiography was performed in AMD subjects; color images were obtained in both. Blood was drawn for genetic analysis. Images were divided into concentric circles and sectors using a grid superimposed on the images. 270 degrees of the retina had to be present or the images were not read. Peripheral features included drusen, peripheral reticular pigmentation (PREP), pavingstone degeneration, hyperpigmentation and reticular drusen. If an eye showed >20 drusen in any clock-hour, dense drusen were present, otherwise they were deemed sporadic. Findings were confirmed by masked readers, including presence and extent of abnormalities. Findings from angiography were compared to those from color images, and eyes with dry AMD to those with wet AMD. As part of Opera Croatia, we also assessed the presence of various AMD related genetic polymorphisms in the groups.


280 AMD eyes and 285 control eyes had readable images covering at least 270 degrees. Peripheral Reticular Pigmentation (PREP) occurred significantly more frequently in AMD eyes compared to controls (40% vs 8% (P<0.05)) PREP was detected more frequently and was easier to see using fluorescein angiography compared to color imaging alone, but the frequency difference was not significant. Dense drusen and any drusen were found in significantly more AMD eyes than in controls. With respect to peripheral drusen occurence, we found with FA that dry AMD eyes showed peripheral drusen in 56% of eyes vs 44% in wet AMD eyes (P=0.017). This difference was not detected using color images. Regarding genetic results, eyes with AMD more likely to have ARMS2(1040924), HTRA1, and CFH (1061170 and 1410996) polymorphisms compared to controls (P<0.01 for all).


Peripheral reticular pigmentation occurs more frequently in AMD eye versus controls as does paving stone degeneration. Eyes with dry AMD were more likely to have peripheral drusen compared to wet AMD eyes, but to detect this difference fluorescein angiographic images were needed, presumably because the higher contrast is conducive to better drusen detection.


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