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  • Peripheral Retinal Changes Associated With AMD in AREDS2

    By Marianne Doran and selected by George B. Bartley, MD
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    Journal Highlights

    Ophthalmology, April 2017

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    The OPERA (Optos PEripheral RetinA) Research Study Group compared rates of peripheral retinal changes in Age-Related Eye Disease Study 2 (AREDS2)participants with at least intermediate age-related macular degeneration (AMD) versus control subjects without intermediate age-related changes (large drusen). The researchers found that peripheral retinal changes are more prevalent in eyes with AMD than in control eyes. Drusen were seen in a majority of eyes with AMD in both the mid- and far periphery.

    This ancillary AREDS2 study, a cross-sectional evaluation of clinic-based patients, included 484 AREDS2 participants (951 eyes) with AMD (cases) and 89 controls (163 eyes) without AMD who had gradable color and fundus autofluorescence (FAF) images. The 200-degree pseudocolor and FAF images were captured using an Optos 200 Tx Ultrawide-field device. The montaged images were graded at a reading center, with the images divided into 3 zones: zone 1, posterior pole; zone 2, midperiphery; and zone 3, far periphery. The main outcome measures were peripheral retinal lesions: drusen, hypo- or hyperpigmentary changes, reticular pseudodrusen, senile reticu­lar pigmentary changes, cobblestone degeneration, and FAF abnormalities.

    In zones 2 and 3, neovascularization and geographic atrophy (GA) were present, ranging from 0.4% to 6% in eyes of cases, respectively; while GA was present in 1% of eyes of controls. Drusen were detected in 97%, 78%, and 64% of eyes of cases; and in 48%, 21%, and 9% of eyes of controls in zones 2 and 3 superior and 3 inferior, respectively.

    The researchers conclud­ed that peripheral retinal changes are more prevalent in eyes with AMD than in control eyes. In a majority of eyes with AMD, drusen are seen in both the mid- and far periphery, whereas pigmen­tary changes and features of advanced AMD are seen less frequently. The findings suggest that AMD should be considered more than just a macular condition, as it appears to involve the entire retina.

    The original article can be found here.