June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Age-related Macular Degeneration Prevalence and Staging by Color Fundus Photography vs Multimodal Imaging. The Coimbra Eye Study
Author Affiliations & Notes
  • Claudia Farinha
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
    Centro Hosp e Univ de Coimbra, Coimbra, Portugal
  • Maria da Luz Cachulo
    Centro Hosp e Univ de Coimbra, Coimbra, Portugal
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • Dalila Alves
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • Isabel Pires
    Centro Hosp e Univ de Coimbra, Coimbra, Portugal
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • Joao Pedro Marques
    Centro Hosp e Univ de Coimbra, Coimbra, Portugal
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • Patricia Barreto
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • Sandrina Nunes
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • José Costa
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • Amelia Martins
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • Isa Sobral
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
    Centro Hosp e Univ de Coimbra, Coimbra, Portugal
  • Ines Lains
    Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Luisa Ribeiro
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • Joao Figueira
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
    Centro Hosp e Univ de Coimbra, Coimbra, Portugal
  • Jose G Cunha-Vaz
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • Rufino Silva
    Centro Hosp e Univ de Coimbra, Coimbra, Portugal
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • Footnotes
    Commercial Relationships   Claudia Farinha, Novartis (C); Maria da Luz Cachulo, None; Dalila Alves, None; Isabel Pires, None; Joao Pedro Marques, Bayer (C), Novartis (C); Patricia Barreto, None; Sandrina Nunes, None; José Costa, None; Amelia Martins, None; Isa Sobral, None; Ines Lains, None; Luisa Ribeiro, None; Joao Figueira, Alcon (C), Alimera (C), Allergan (C), Bayer (C), Novartis (C), Pfizer (C); Jose Cunha-Vaz, , Novartis, (C), Alimera Sciences (C), Allergan (C), Bayer (C), Carl Zeiss Meditec (C), Gene Signal (C), Pfizer (C), Precision Ocular Ltd. (C), Roche (C), Sanofi-Aventis (C), Vifor Pharma (C); Rufino Silva, Alcon (C), Alimera Sciences (C), Allergan (C), Bayer (C), Novartis (C), Thea (C)
  • Footnotes
    Support  Novartis Grant
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4187. doi:
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      Claudia Farinha, Maria da Luz Cachulo, Dalila Alves, Isabel Pires, Joao Pedro Marques, Patricia Barreto, Sandrina Nunes, José Costa, Amelia Martins, Isa Sobral, Ines Lains, Luisa Ribeiro, Joao Figueira, Jose G Cunha-Vaz, Rufino Silva; Age-related Macular Degeneration Prevalence and Staging by Color Fundus Photography vs Multimodal Imaging. The Coimbra Eye Study. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4187.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To compare the prevalence and staging of AMD using color fundus photography (CFP) grading only to grading using a multimodal approach with CFP, SD-OCT, infra-red (IR) and fundus autofluorescence (FAF), in the scope of the epidemiologic Coimbra Eye Study (CES).

Methods : Population-based cohort study. Participants underwent standardized interviews and ophthalmologic examination in the context of the CES for the prevalence and incidence of AMD in the central region of Portugal. Color fundus photographs were graded according to the International Classification and Grading System for AMD and ARM and staged using the Rotterdam classification. After the first grading all CFP images were reviewed with SD-OCT, IR and FAF imaging in a multimodal manner and a new classification was performed with stage update whenever necessary. The crude and age-standardized prevalence of early and late AMD was calculated for each grading approach and the staging differences were analyzed.

Results : We analyzed all 1,616 subjects included in the follow-up analysis of the CES (coastal town cohort). Using CFP grading only the crude prevalence was 14.11% for early AMD (n=228) and 1.11% (n=18) for late AMD, whereas the age-standardized prevalence was 13.97% (95% CI, 11.82%-16.12%) for early AMD and 1.36% (95% CI, 0.64%-2.08%) for late AMD. There were 11 cases (0.68%) of neovascular AMD (nAMD) and 7 (0.43%) of geographic atrophy (GA). When using a multimodal approach, the crude prevalence was 14.54% for early AMD (n=235) and 1.8% (n=29) for late AMD, and the age-standardized prevalence was 14.97% (95% CI, 12.76%-17.18%) for early AMD and 2.28% (95% CI, 1.35%-3.21%) for late AMD. With multimodal approach there were 17 detected cases (1.05%) of nAMD and 12 cases (0.74%) of GA. Globally, the difference in prevalence between staging strategies was 1.55% (95%CI, 1.49–1.61), however, it increased to 37.93% (95%CI, 34.92%–40.94%) when analyzing late AMD only.

Conclusions : AMD staging is more accurate using a multimodal approach compared to a CFP only based analysis. This was especially true for the correct identification of late AMD and the difference between the 2 methods was substantial in our population. Therefore, multimodal imaging should be adopted in future major epidemiologic studies to better estimate AMD prevalence and incidence in different populations.

This is a 2020 ARVO Annual Meeting abstract.

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