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S. M. Cisneros, IV, A. W. Foong, M. Y. Lai, S. Azen, R. Klein, J. Chung, R. Varma; Relation of Drusen Type at Baseline to Four-Year Incidence of Age-Related Macular (AMD) Lesions in a Population-Based Cohort of Adult Latinos: The Los Angeles Latino Study (LALES). Invest. Ophthalmol. Vis. Sci. 2008;49(13):602.
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To evaluate the relation of baseline drusen type to the 4-year incidence of pigmentary abnormalities, geographic atrophy and exudative macular degeneration in a population-based sample of Latinos.
Data for this analysis is derived from LALES, primarily Mexican-American persons aged 40 years and older at baseline. All participants underwent a series of evaluations at baseline and at four years of follow-up. The evaluations included stereoscopic fundus photography using standard protocol. Baseline and follow-up photographs were graded for AMD characteristics using a modified Wisconsin Age-Related Maculopathy Grading System. The 4-year risk of developing RPE pigmentary abnormalities, geographic atrophy or exudative AMD, based on drusen type (none, hard distinct, soft distinct, soft indistinct) at baseline was calculated.
Of the 3435 Latinos with gradable fundus photographs at both baseline and follow-up examinations, 498 (14.49%) had no drusen, 2438 (70.97%) had hard distinct drusen, 367 (10.68%) had soft distinct drusen and 132 (3.84%) had soft indistinct drusen at baseline. The 4-year incidence of pigmentary abnormalities in persons with no drusen, hard distinct, soft distinct, and soft indistinct drusen at baseline was 0.4%, 0.4%, 3.5% and 19.2%, respectively. In the same drusen categories, the 4-year incidence of geographic atrophy was 0%, 0%, 0% and 2.3%, respectively, while the 4-year incidence of exudative AMD was 0%, 0%, 0.3% and 1.5%, respectively. These results showed that persons with soft indistinct drusen at baseline had significantly higher risk of developing RPE pigmentary abnormalities geographic atrophy or exudative AMD than those with none, hard indistinct or soft distinct drusen (P<0.001).
Our findings demonstrate that soft indistinct drusen are more likely to predict the 4-year incidence of RPE pigmentary abnormalities, geographic atrophy, and exudative macular degeneration than other drusen types.
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