Associations Between Early Signs Of Age-related Macular Degeneration (AMD) And Risk Of AMD In The Fellow Eye In Patients With Unilateral AMD

Abstract

Purpose: : Soft drusen and retinal pigment abnormalities are well recognized as early signs of age-related macular degeneration (AMD). However, their association with risk of AMD in Asian patients is unclear. In this study, we aimed to determine, in patients with unilateral AMD or polypoidal choroidal vasculopathy (PCV), the relationship between early signs of AMD the incidence of AMD developing in the fellow eye.

Methods: : We identified 132 patients (104 men, 28 women; average age 69.2±9.3 years old) who had unilateral AMD/PCV at their first visit and who had been attended our clinic at least 12 months (average follow-up period: 4.5 years). Study participants were categorized into 4 groups based on the presence of soft indistinct drusen and/or pigment abnormalities in the fellow eye: (1) no early signs (N group), (2) soft indistinct drusen only (D), (3) pigment abnormalities only (P), and (4) soft indistinct drusen and pigment abnormalities (D+P). AMD without PCV (‘typical AMD’) or PCV were determined by funduscopic findings, fluorescein/indocyanine green angiography and optical coherence tomography findings. Using multivariate logistic regression models, odds ratios were estimated.

Results: : Of 132 patients with unilateral AMD/PCV at baseline, 16 patients developed AMD (7 with PCV) in the fellow eye during follow-up period (3.7% N, 2 patients [11.8%]. After adjusting for age and gender, patients in group P (OR 7.03, 95% CI: 1.27-38.8, p=0.03) and group D+P (OR 5.31, 95% CI: 0.98-28.8, p=0.05) were more likely to develop AMD/PCV when compared to group N. Group D+P were more likely to develop typical AMD (OR 9.3, 95% CI: 1.03-84.1, p=0.047), while group P (OR 14.5, 95% CI: 1.55-136.2, p = 0.02) were more likely to have PCV when compared to Group N.

Conclusions: : Pigment abnormalities, with or without drusen, were associated with risk of AMD in fellow eyes in patients with unilateral AMD/PCV in one eye. Eyes with pigment abnormalities and drusen were more likely to develop typical AMD, while eyes with pigment abnormalities without drusen were more likely to develop PCV.

Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: prevalence/incidence • drusen