This Article  • Full text  • PDF  • Correction  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in this journal  Topic Collections  • Macular Degeneration  • Articles for Residents  • Alert me on articles by topic  Social Bookmarking   What's this?

AREDS Report No. 17

Age-Related Eye Disease Study Research Group^*

Arch Ophthalmol. 2005;123:1484-1498.

Objective  To develop a fundus photographic severity scale for age-related macular degeneration (AMD).

Methods  In the Age-Related Eye Disease Study, stereoscopic color fundus photographs were taken at baseline, at the 2-year follow-up visit, and annually thereafter. Photographs were graded for drusen characteristics (size, type, area), pigmentary abnormalities (increased pigment, depigmentation, geographic atrophy), and presence of abnormalities characteristic of neovascular AMD (retinal pigment epithelial detachment, serous or hemorrhagic sensory retinal detachment, subretinal or sub–retinal pigment epithelial hemorrhage, subretinal fibrous tissue). Advanced AMD was defined as presence of 1 or more neovascular AMD abnormalities, photocoagulation for AMD, or geographic atrophy involving the center of the macula. We explored associations among right eyes of 3212 participants between severity of drusen characteristics and pigmentary abnormalities at baseline and development of advanced AMD within 5 years of follow-up.

Results  A 9-step severity scale that combines a 6-step drusen area scale with a 5-step pigmentary abnormality scale was developed, on which the 5-year risk of advanced AMD increased progressively from less than 1% in step 1 to about 50% in step 9. Among the 334 eyes that had at least a 3-step progression on the scale between the baseline and 5-year visits, almost half showed stepwise progression through intervening severity levels at intervening visits. Replicate gradings showed agreement within 1 step on the scale in 87% of eyes.

Conclusions  The scale provides convenient risk categories and has acceptable reproducibility. Progression along it may prove to be useful as a surrogate for progression to advanced AMD.

*The Writing Team for the Age-Related Eye Disease Study (AREDS) Research Group consisted of Matthew D. Davis, MD; Ronald E. Gangnon, PhD; Li-Yin Lee, MS; Larry D. Hubbard, MA; Barbara E. K. Klein, MD; Ronald Klein, MD; Frederick L. Ferris, MD; Susan B. Bressler, MD and Roy C. Milton, PhD.
Group Information: A complete list of the members of the AREDS Research Group appears in Arch Ophthalmol. 2004;122:723-724.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

A Simplified Severity Scale for Age-Related Macular Degeneration: AREDS Report No. 18
Age-Related Eye Disease Study Research Group
Arch Ophthalmol. 2005;123(11):1570-1574.
ABSTRACT | FULL TEXT  

Age-Related Eye Disease Study Severity Scale and Simplified Severity Scale for Age-Related Macular Degeneration
Paul Mitchell and Suriya Foran
Arch Ophthalmol. 2005;123(11):1598-1599.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Description of the Age-Related Eye Disease Study 9-Step Severity Scale Applied to Participants in the Complications of Age-related Macular Degeneration Prevention Trial
Ying et al.
Arch Ophthalmol 2009;127:1147-1151.
ABSTRACT | FULL TEXT  

Projection OCT fundus imaging for visualising outer retinal pathology in non-exudative age-related macular degeneration
Gorczynska et al.
Br J Ophthalmol 2009;93:603-609.
ABSTRACT | FULL TEXT  

Forecasting Age-Related Macular Degeneration Through the Year 2050: The Potential Impact of New Treatments
Rein et al.
Arch Ophthalmol 2009;127:533-540.
ABSTRACT | FULL TEXT  

Spectral domain optical coherence tomography for quantitative evaluation of drusen and associated structural changes in non-neovascular age-related macular degeneration
Yi et al.
Br J Ophthalmol 2009;93:176-181.
ABSTRACT | FULL TEXT  

Evaluation of Time Domain and Spectral Domain Optical Coherence Tomography in the Measurement of Diabetic Macular Edema
Forooghian et al.
IOVS 2008;49:4290-4296.
ABSTRACT | FULL TEXT  

Brightness, Contrast, and Color Balance of Digital versus Film Retinal Images in the Age-Related Eye Disease Study 2
Hubbard et al.
IOVS 2008;49:3269-3282.
ABSTRACT | FULL TEXT  

Mitochondrial Proteomics of the Retinal Pigment Epithelium at Progressive Stages of Age-Related Macular Degeneration
Nordgaard et al.
IOVS 2008;49:2848-2855.
ABSTRACT | FULL TEXT  

Racial Differences and Other Risk Factors for Incidence and Progression of Age-Related Macular Degeneration: Salisbury Eye Evaluation (SEE) Project
Chang et al.
IOVS 2008;49:2395-2402.
ABSTRACT | FULL TEXT  

Genotype-phenotype correlation of age-related macular degeneration: influence of complement factor H polymorphism
Droz et al.
Br J Ophthalmol 2008;92:513-517.
ABSTRACT | FULL TEXT  

Prevalence and Morphology of Druse Types in the Macula and Periphery of Eyes with Age-Related Maculopathy
Rudolf et al.
IOVS 2008;49:1200-1209.
ABSTRACT | FULL TEXT  

Racial Differences in the Prevalence of Age-Related Macular Degeneration: The Salisbury Eye Evaluation (SEE) Project
Bressler et al.
Arch Ophthalmol 2008;126:241-245.
ABSTRACT | FULL TEXT  

The Relationship of Dietary Carotenoid and Vitamin A, E, and C Intake With Age-Related Macular Degeneration in a Case-Control Study: AREDS Report No. 22
Age-Related Eye Disease Study Research Group
Arch Ophthalmol 2007;125:1225-1232.
ABSTRACT | FULL TEXT  

Age-Related Macular Degeneration and Retinal Protein Modification by 4-Hydroxy-2-nonenal
Ethen et al.
IOVS 2007;48:3469-3479.
ABSTRACT | FULL TEXT  

Cigarette Smoking, CFH, APOE, ELOVL4, and Risk of Neovascular Age-Related Macular Degeneration
DeAngelis et al.
Arch Ophthalmol 2007;125:49-54.
ABSTRACT | FULL TEXT  

Complement activation by photooxidation products of A2E, a lipofuscin constituent of the retinal pigment epithelium
Zhou et al.
Proc. Natl. Acad. Sci. USA 2006;103:16182-16187.
ABSTRACT | FULL TEXT  

Plasma apolipoproteins and risk for age related maculopathy
Dashti et al.
Br J Ophthalmol 2006;90:1028-1033.
ABSTRACT | FULL TEXT  

Effect of short-term, high-dose retinol on dark adaptation in aging and early age-related maculopathy.
Owsley et al.
IOVS 2006;47:1310-1318.
ABSTRACT | FULL TEXT  

A Simplified Severity Scale for Age-Related Macular Degeneration: AREDS Report No. 18
Age-Related Eye Disease Study Research Group
Arch Ophthalmol 2005;123:1570-1574.
ABSTRACT | FULL TEXT  

Age-Related Eye Disease Study Severity Scale and Simplified Severity Scale for Age-Related Macular Degeneration
Mitchell and Foran
Arch Ophthalmol 2005;123:1598-1599.
FULL TEXT