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Stacy M. Meuer, Chelsea E. Myers, Ronald Klein, Barbara E. Klein; Does The AREDS Simplified Severity Scale Predict The Development Of Late AMD Over 15 Years? The Beaver Dam Eye Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):85.
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To determine whether the Age-Related Eye Disease Study (AREDS) simplified severity scale predicts the fifteen year incidence of late age-related macular degeneration (AMD) in the Beaver Dam Eye Study (BDES).
Of 4,926 persons, 43-86 years of age at the time of a baseline examination in 1988-1990, living in Beaver Dam, Wisconsin, 3,645 persons, with information collected in follow-up in 1993-95, and/or 1998-2000, and/or 2003-05 were included in this analysis. Stereoscopic 30° color fundus photographs of fields 1 and 2 were taken at each visit and graded in a masked fashion using the standardized Wisconsin Age-Related Maculopathy Grading Scheme. Two scores, one using the AREDS simplified severity scale based only on drusen size >125 um in diameter and/or presence of pigmentary abnormalities (PA) and the other the more detailed BDES-AMD grading that included drusen size and area, as well as presence of PA was assigned to each eye at baseline.
Over 15 years there were 89 study participants who developed late AMD. Controlling for age, the cumulative incidence of late AMD accounting for the competing risk of death was 2.0% (95% CI 0.3 - 4.3%), 8.9 (3.1 - 14.6%), 16.0% (5.9, 26.1%), 34.7% (16.2 - 53.2%), and 32.3% (16.3- 48.4%) for individuals with a baseline AREDS clinical score of 0,1,2,3 and 4, respectively. In a similar analysis using the first 4 steps of the BDES severity scale the cumulative incidence was 1.0% (95% CI 0.5 - 1.5%), 5.2% (2.3 - 8.1%), 22.0% (13.4, 30.6%), and 39.5% (24.4 - 54.6%). The BDES 6-level AMD scale independently added to the predictive ability of the AREDS scale for late AMD (p<0.01) with an improvement of the R2 from 0.44 to 0.46..
The AREDS simplified AMD severity scale predicts progression to late AMD in the BDES cohort and while the BDES 6-step scale leads to a small improvement, both AMD severity scales result in similar findings regarding prediction of late AMD.
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