Abstract
Purpose :
To investigate the association between lesions of the peripheral retina and those at the macula in relation to Age related macular degeneration (AMD) in a population based sample of ageing individuals.
Methods :
Ultra-wide field images (UWFI) (Optomap 200 TX) were obtained from the Northern Ireland Cohort of the Longitudinal Study of Aging (NICOLA Study) participants. UWFI were graded for the presence of AMD-like features; soft drusen (SD), retinal pigment epithelial (RPE) changes, geographic atrophy (GA) and choroidal neovascularisation (CNV) using the Manchester Grid (MG), which covers the image with 400 boxes, each approximately one disc area in size. The retina was divided into the macular and peripheral regions using defined x- and y-coordinates on the MG. Descriptive statistics were used to describe the presence and absence of each retinal lesion associated with AMD.
Results :
Altogether 3044 images were available from 1576 participants (Mean age=64 years, SD=+/-9.02). No abnormality was observed in 2523 eyes. AMD features were observed in either region in 521 eyes (17%), with 86 (16.6%) showing these in both central and peripheral retina. SD were observed in both central and peripheral retina in 23 eyes (4.4%). SD was present only in the central or peripheral region in 130 (25%) and 7 eyes (1.3%) respectively. RPE changes in both central and peripheral regions were found in 45 eyes (8.6%); and only in the peripheral region in 35 (6.7%) while SD were found in the central region. RPE changes were present either in the central or peripheral region in 12 (2.3%) and 338 eyes (64.8%) respectively. On one eye where RPE changes were detected in the periphery, GA was present in the central region. The prevalence of RPE changes increased from the centre (10.9%) to the periphery (73.5%). SD were most prevalent in the centre (29.4%) and decreased in the peripheral retina (5.8%). GA (1.9%) and CNV (0.2%) were only present in the central region.
Conclusions :
In most patients if AMD features were present in the central region they were also found in the peripheral retina, raising the questions as to how they might contribute to macular disease and to visual function. Whether peripheral abnormalities may be associated with the development or progression of central changes remains unclear and requires further investigation.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.