Drusen classification in bilateral drusen and fellow eye of exudative AMD

Abstract

Abstract: : Purpose: Choroidal neovascularisation (CNV) is the leading cause of blindness in the developed world. It is known that the fellow eye of exudative age–related macular degeneration (AMD) is more likely to develop CNV. We compared the staging of drusen in patients with bilateral age–related maculopathy (ARM) and those of the fellow eye of exudative age–related macular degeneration (AMD). Methods: Images from consecutive patients referred to the Macular clinic of King’s College Hospital were included in the study. Patients with no ARM in both eyes and bilateral disciform scars were excluded. The images were graded by two ophthalmic interns independently based on the modified International Classification of ARM. Results: There were 52 images of patients with bilateral ARM and 38 images of the fellow eye of patients with CNV. The interobserver Kappa was 0.58. 

* denotes statistically significant different Conclusion: Hard drusen (stage 0b) and soft distinct drusen (Stage 1a) were significantly more common in bilateral ARM, this might denote early stage of the disease and have low risk of developing CNV. However, pigmentary changes without drusen (stage 1b) and with soft distinct drusen (stage 2b) were significantly more common in the fellow eye of exudative CNV, this feature might suggest high risk of developing CNV.

Keywords: age–related macular degeneration • drusen