June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Progression of Age-Related Macular Degeneration measured by Ultrawidefield Imaging in the Age-Related Eye Disease Study 2 10 Year Follow-On
Author Affiliations & Notes
  • Claire E Malley
    Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
  • Elvira Agron
    Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
  • Tiarnan D L Keenan
    Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
  • Traci E Clemons
    The Emmes Company LLC, Rockville, Maryland, United States
  • Amitha Domalpally
    Department of Ophthalmology, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • Tunde Peto
    Queen's University Belfast, Belfast, Ireland
  • Wai T Wong
    Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
    Queen's University Belfast, Belfast, Ireland
  • Emily Y Chew
    Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
  • Footnotes
    Commercial Relationships   Claire Malley, None; Elvira Agron, None; Tiarnan Keenan, None; Traci Clemons, The Emmes Corporation (E); Amitha Domalpally, None; Tunde Peto, None; Wai Wong, None; Emily Chew, None
  • Footnotes
    Support  NIH Grant N01-EY-5-0007
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 215. doi:
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    • Get Citation

      Claire E Malley, Elvira Agron, Tiarnan D L Keenan, Traci E Clemons, Amitha Domalpally, Tunde Peto, Wai T Wong, Emily Y Chew; Progression of Age-Related Macular Degeneration measured by Ultrawidefield Imaging in the Age-Related Eye Disease Study 2 10 Year Follow-On. Invest. Ophthalmol. Vis. Sci. 2021;62(8):215.

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

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Abstract

Purpose : To describe the age-related macular degeneration (AMD) features on ultrawidefield (UWF) retinal imaging in the participants of the Age-Related Eye Disease Study 2 (AREDS2) 10 Year Follow-on Study.

Methods : OPTOS (Dunfermline, Scotland) color and fundus autofluorescence retinal (UWF) images were obtained at year 10 study visit in AREDS2 participants with intermediate or late AMD in one eye (N=230). Reading centers (U. of Wisconsin and Queen’s University, Belfast) graded the images for presence and extent of: macula change, neovascular AMD, geographic atrophy (GA), drusen, reticular pseudodrusen (RPD), RPE pigmentary changes (hyper and hypo), peripheral pathology including cobblestone and senile reticular pigmentary changes. The images were divided into 3 zones: posterior pole (zone 1), midperiphery (zone 2), and far periphery (zone 3) and further divided into four image quadrants. RPD was diagnosed based upon the fundus autofluorescence imaging. AMD features were summarized by each of the zones and the 4 quadrants.

Results : Of the 230 AREDS2 participants, mean age was 69 ± 1 year, 59% female, 90% have late AMD (Figure). Only 13% presented neovascular AMD while most had GA and a minority presented inactive neovascular AMD. Almost half of the GA lesions were unifocal, and about 89% of the macula had GA. More than 80% had super large drusen (≥ 250 µm) and 25% had RPD. 71% had peripheral retinal abnormalities. Zone 2 had marked drusen, pigmentary changes, floaters, and GA. All three zones had demonstrated extensive AMD lesions throughout the macula and in the periphery.

Conclusions : The results of the 10-year follow-on of AREDS2 participants demonstrate the extensive and relentless progression of the AMD lesions. The disease is not confined to the macula but extensive throughout the retinal and its periphery. Future evaluation of AMD progression will need to take into account lesions that occur in the retinal periphery as well as the macula. It will also be important to correlate structural changes with functional deficits. This study also demonstrates that AMD is a pan-retinal disease.

This is a 2021 ARVO Annual Meeting abstract.

 

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