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Peripheral Retinal Changes Associated with Age-Related Macular Degeneration in the Age-Related Eye Disease Study 2: Age-Related Eye Disease Study 2 Report Number 12 by the Age-Related Eye Disease Study 2 Optos PEripheral RetinA (OPERA) Study Research Group.

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Writing Committee for the OPTOS PEripheral RetinA (OPERA) study (Ancillary Study of Age-Related Eye Disease Study 2), ; Domalpally, A; Clemons, TE ...
Published in: Ophthalmology
April 2017

PURPOSE: To compare rates of peripheral retinal changes in Age-Related Eye Disease Study 2 (AREDS2) participants with at least intermediate age-related macular degeneration (AMD) with control subjects without intermediate age-related changes (large drusen). DESIGN: Cross-sectional evaluation of clinic-based patients enrolled in AREDS2 and a prospective study. PARTICIPANTS: Participants from prospective studies. METHODS: The 200° pseudocolor and fundus autofluorescence (FAF) images were captured on the Optos 200 Tx Ultrawide-field device (Optos, Dunfermline, Scotland) by centering on the fovea and then steering superiorly and inferiorly. 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]) to document the presence of peripheral lesions. MAIN OUTCOME MEASURES: Peripheral retinal lesions: drusen, hypopigmentary/hyperpigmentary changes, reticular pseudodrusen, senile reticular pigmentary changes, cobblestone degeneration, and FAF abnormalities. RESULTS: A total of 484 (951 eyes) AREDS2 participants with AMD (cases) and 89 (163 eyes) controls without AMD had gradable color and FAF images. In zones 2 and 3, neovascularization and geographic atrophy (GA) were present, ranging from 0.4% to 6% in eyes of cases, respectively, and GA was present in 1% of eyes of controls. Drusen were detected in 97%, 78%, and 64% of eyes of cases and 48%, 21%, and 9% of eyes of controls in zones 2 and 3 superior and 3 inferior, respectively (P < 0.001 for all). Peripheral reticular pseudodrusen were seen in 15%. Senile reticular pigmentary change was the predominant peripheral change seen in 48% of cases and 16% of controls in zone 2 (P < 0.001). Nonreticular pigment changes were less frequent in the periphery than in the posterior pole (46% vs. 76%) and negligible in controls. CONCLUSIONS: Peripheral retinal changes are more prevalent in eyes with AMD than in control eyes. Drusen are seen in a majority of eyes with AMD in both the mid and far periphery, whereas pigment changes and features of advanced AMD are less frequent. Age-related macular degeneration may be more than a "macular" condition but one that involves the entire retina. Future longitudinal studies of peripheral changes in AMD and their impact on visual function may contribute to understanding AMD pathogenesis.

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Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

April 2017

Volume

124

Issue

4

Start / End Page

479 / 487

Location

United States

Related Subject Headings

  • Zeaxanthins
  • Wet Macular Degeneration
  • Tomography, Optical Coherence
  • Retinal Pigment Epithelium
  • Retinal Drusen
  • Retina
  • Prospective Studies
  • Optical Imaging
  • Ophthalmology & Optometry
  • Middle Aged
 

Citation

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Writing Committee for the OPTOS PEripheral RetinA (OPERA) study (Ancillary Study of Age-Related Eye Disease Study 2), ., Domalpally, A., Clemons, T. E., Danis, R. P., Sadda, S. R., Cukras, C. A., … Chew, E. Y. (2017). Peripheral Retinal Changes Associated with Age-Related Macular Degeneration in the Age-Related Eye Disease Study 2: Age-Related Eye Disease Study 2 Report Number 12 by the Age-Related Eye Disease Study 2 Optos PEripheral RetinA (OPERA) Study Research Group. Ophthalmology, 124(4), 479–487. https://doi.org/10.1016/j.ophtha.2016.12.004
Writing Committee for the OPTOS PEripheral RetinA (OPERA) study (Ancillary Study of Age-Related Eye Disease Study 2), Emily Y., Amitha Domalpally, Traci E. Clemons, Ronald P. Danis, SriniVas R. Sadda, Catherine A. Cukras, Cynthia A. Toth, Thomas R. Friberg, and Emily Y. Chew. “Peripheral Retinal Changes Associated with Age-Related Macular Degeneration in the Age-Related Eye Disease Study 2: Age-Related Eye Disease Study 2 Report Number 12 by the Age-Related Eye Disease Study 2 Optos PEripheral RetinA (OPERA) Study Research Group.Ophthalmology 124, no. 4 (April 2017): 479–87. https://doi.org/10.1016/j.ophtha.2016.12.004.
Writing Committee for the OPTOS PEripheral RetinA (OPERA) study (Ancillary Study of Age-Related Eye Disease Study 2), Domalpally A, Clemons TE, Danis RP, Sadda SR, Cukras CA, et al. Peripheral Retinal Changes Associated with Age-Related Macular Degeneration in the Age-Related Eye Disease Study 2: Age-Related Eye Disease Study 2 Report Number 12 by the Age-Related Eye Disease Study 2 Optos PEripheral RetinA (OPERA) Study Research Group. Ophthalmology. 2017 Apr;124(4):479–87.
Writing Committee for the OPTOS PEripheral RetinA (OPERA) study (Ancillary Study of Age-Related Eye Disease Study 2), Emily Y., et al. “Peripheral Retinal Changes Associated with Age-Related Macular Degeneration in the Age-Related Eye Disease Study 2: Age-Related Eye Disease Study 2 Report Number 12 by the Age-Related Eye Disease Study 2 Optos PEripheral RetinA (OPERA) Study Research Group.Ophthalmology, vol. 124, no. 4, Apr. 2017, pp. 479–87. Pubmed, doi:10.1016/j.ophtha.2016.12.004.
Writing Committee for the OPTOS PEripheral RetinA (OPERA) study (Ancillary Study of Age-Related Eye Disease Study 2), Domalpally A, Clemons TE, Danis RP, Sadda SR, Cukras CA, Toth CA, Friberg TR, Chew EY. Peripheral Retinal Changes Associated with Age-Related Macular Degeneration in the Age-Related Eye Disease Study 2: Age-Related Eye Disease Study 2 Report Number 12 by the Age-Related Eye Disease Study 2 Optos PEripheral RetinA (OPERA) Study Research Group. Ophthalmology. 2017 Apr;124(4):479–487.
Journal cover image

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

April 2017

Volume

124

Issue

4

Start / End Page

479 / 487

Location

United States

Related Subject Headings

  • Zeaxanthins
  • Wet Macular Degeneration
  • Tomography, Optical Coherence
  • Retinal Pigment Epithelium
  • Retinal Drusen
  • Retina
  • Prospective Studies
  • Optical Imaging
  • Ophthalmology & Optometry
  • Middle Aged