Skip to main content
  • Peripheral Retinal Changes Associated With AMD in AREDS2

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

    Journal Highlights

    Ophthalmology, April 2017

    Download PDF

    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.