Methods and Reproducibility of Grading Optimized Digital Color Fundus Photographs in the Age-Related Eye Disease Study 2 (AREDS2 Report Number 2)

Danis, Ronald P.; Domalpally, Amitha; Chew, Emily Y.; Clemons, Traci E; Armstrong, J.; SanGiovanni, John Paul; Ferris, Frederick L.

doi:10.1167/iovs.13-11804

Cited by 102 publications

(99 citation statements)

References 28 publications

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“…The AREDS definitions are based on CFP only and have been altered over time. 32,34 The AMD classification by Ferris and coworkers, 44 also based on CFP or clinical examination, does not define a minimum size of atrophy. Given the major technological advances in retinal imaging, more detailed classification and definition are prudent.…”

Section: Discussionmentioning

confidence: 99%

“…32 Second, derived from the revised definition (as introduced in 2013), the lesion had to be at least as large as circle I-2, corresponding to one-fourth disc diameter or 450 lm in diameter, also taking into account the change in size of the standard disc area from 1500 to 1800 lm (CFP-II). 34,35 Finally, based on findings by multimodal imaging, development of central atrophy was defined as the presence of cRORA. These included the following specific OCT-based criteria: (1) region of hypertransmission of at least 250 lm in diameter; (2) a zone of attenuation or disruption of the RPE of at least 250 lm in diameter; (3) evidence of overlying photoreceptor degeneration including loss of the interdigitation zone, ellipsoid zone, and external limiting membrane as well as thinning of the outer nuclear layer; and (4) absence of scrolled RPE or other signs of RPE tear.…”

Section: Definitions and Gradingmentioning

confidence: 99%

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Multimodal Imaging Patterns for Development of Central Atrophy Secondary to Age-Related Macular Degeneration

Thiele

Pfau

Larsen

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To evaluate the development of central atrophy in eyes with age-related macular degeneration (AMD).METHODS. Six-year longitudinal multimodal retinal imaging data (MODIAMD study) from 98 eyes of 98 subjects with non-late-stage AMD in the study eye at baseline were analyzed for the presence of central atrophy at each annual follow-up visit. Development, manifestation, and further progression of complete retinal pigment epithelium and outer retinal atrophy (cRORA) by multimodal imaging data were compared with atrophy detection based on color fundus photography only.RESULTS. Seventeen study eyes with development of central cRORA within 6 years (cumulative rate: 17.4%) were identified based on multimodal imaging. In 10 (60%) of these eyes, presence of central manifest atrophy was initially not detectable by color fundus photography. In six (35%) eyes, central cRORA occurred by the spread of existing paracentral atrophy toward the fovea. Drusen-associated atrophy development was noted in eight eyes. In two eyes, atrophy development was associated with refractile deposits, while only pigmentary changes in absence of large drusen or refractile deposits were detectable before atrophy occurrence in one eye.CONCLUSIONS. The earlier and more precise detection of central cRORA by multimodal imaging as compared to atrophy detection solely based on color fundus photography allows for more accurate detection and identification of different pathways for atrophy development. In accordance with previous clinical and histopathologic reports, the results confirm that different precursor lesions may independently proceed to central cRORA in AMD.

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Section: Discussionmentioning

confidence: 99%

Section: Definitions and Gradingmentioning

confidence: 99%

Multimodal Imaging Patterns for Development of Central Atrophy Secondary to Age-Related Macular Degeneration

Thiele

Pfau

Larsen

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…4,29 Refractile drusen (sometimes referred to as calcified drusen) were defined as drusen with a brightly glistening appearance in fundus photographs. 31 Each imaging was reviewed by two reviewers masked to the outcome of each other, and if there were discrepancies, there was open adjudication with the senior author.…”

Section: Image Analysismentioning

confidence: 99%

Multimodal Visual Function Testing in Eyes With Nonexudative Age-Related Macular Degeneration

Ooto

Suzuki

Vongkulsiri

et al. 2015

Retina

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“…In effect, the definition and reported values in micrometers should therefore not be regarded as precise measurements but rather as estimations from the beginning. To make things even more complicated, it is noteworthy that the AREDS definition of atrophy doubles the minimal required lesion size of an individual atrophic spot from 1/8 (circle I 1 ) to 1/4 (circle I 2 ) of the standard optic disc and changes the diameter of the standard disc from 1,500 to 1,800 μm at the same time [46] .…”

Section: Definitions Of "Geographic Atrophy" In Natural History Studiesmentioning

confidence: 99%

The Journey of “Geographic Atrophy” through Past, Present, and Future

Schmitz-Valckenberg¹

2017

Ophthalmologica

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“Geographic atrophy” is a concise term that has been firmly established for the description of the end-stage manifestation of nonexudative age-related macular degeneration (AMD). “Geographic lesions” resembling sharply demarcated continents on a map have been originally described in the German literature in 1854 (landkartenartiger/inselförmiger Zungenfratt) for a manifestation later called “geographic tongue” in English. In 1970, Gass was the first to describe “geographic areas of atrophy” in “senile macular choroidal degeneration.” Within a decade, the disease itself was named “geographic atrophy.” Today, various meanings of the term are used in parallel both in research and in routine clinical care. Currently, we are on the verge of better understanding the different forms of atrophy development, manifestation, and progression in AMD, which will pave the way for a more rational approach to their nomenclature and classification.

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Methods and Reproducibility of Grading Optimized Digital Color Fundus Photographs in the Age-Related Eye Disease Study 2 (AREDS2 Report Number 2)

Abstract: Digital color grading has nearly the same reproducibility as historical film grading. There is substantial agreement for testing the predictive utility of the AREDS severity scale in AREDS2 as a clinical trial outcome. (ClinicalTrials.gov number, NCT00345176.)

Cited by 102 publications

References 28 publications

Multimodal Imaging Patterns for Development of Central Atrophy Secondary to Age-Related Macular Degeneration

Multimodal Imaging Patterns for Development of Central Atrophy Secondary to Age-Related Macular Degeneration

Multimodal Visual Function Testing in Eyes With Nonexudative Age-Related Macular Degeneration

The Journey of “Geographic Atrophy” through Past, Present, and Future

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