The Wisconsin Age-related Maculopathy Grading System

Klein, Ronald; Davis, Matthew D.; Magli, Yvonne L.; Segał, P; Klein, Barbara E. K.; Hubbard, Larry D.

doi:10.1016/s0161-6420(91)32186-9

Cited by 1,034 publications

(712 citation statements)

References 18 publications

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“…Standard photographs were selected by a retinal specialist (PM) from the standard photographic set developed for the Modified Airlie House Classification of Diabetic Retinopathy 19 and the Wisconsin Age-related Maculopathy Grading System. 20 Focal arteriolar narrowing was graded as absent/ questionable (none/ less severe than the standard photograph) or present (equal to or more severe than the standard). AV nicking was defined as a decrease in venular width on both sides of the venule where crossed by an arteriole and was graded as absent/questionable, mild (less than the standard), or severe (equal to or greater than the standard).…”

Section: Methodsmentioning

confidence: 99%

Dyslipidaemia and microvascular disease in the retina

Leung

Wang

Rochtchina

et al. 2004

Eye

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Purpose There are few data on the effect of serum lipids on microvascular disease. This study assessed the relationships between serum lipid levels and microvascular disease, as seen in the retina, among participants who attended a population-based study in Australia (n ¼ 3654, aged 49 þ years). Methods Diameters of retinal arterioles and venules were measured from digitised photographs of each participant to obtain an estimate of generalised arteriolar narrowing. Focal arteriolar narrowing, arteriovenous nicking, and retinopathy lesions (microaneurysms, haemorrhages, hard/soft exudates) were graded using a standard protocol. Fasting blood tests were performed in 89% of subjects. Adjusted means were calculated using general linear models. Logistic regression models were used to determine the odds ratios for retinal microvascular signs. Results After controlling for age, sex, body mass index, smoking, and mean arterial blood pressure, elevated high-density lipoprotein cholesterol was associated with narrower retinal arterioles (P trend ¼ 0.002) and venules (P trend ¼ 0.03) and with increased odds of generalised arteriolar narrowing (odds ratio 1.6, 95% confidence interval 1.1-2.2 for the highest vs the lowest quintile of high-density lipoprotein cholesterol). Serum triglyceride had a U-shaped relationship with venular diameter (P trend ¼ 0.003). We found no consistent pattern of association between serum total cholesterol or low-density lipoprotein cholesterol and any retinal microvascular signs. Conclusions These findings suggest that microvascular disease in the retina may result from processes distinct from dyslipidaemia.

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Section: Methodsmentioning

confidence: 99%

Dyslipidaemia and microvascular disease in the retina

Leung

Wang

Rochtchina

et al. 2004

Eye

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“…18,19 These systems have been well validated and exhibit good inter-rater reliability and reproducibility; however, many of these reports have focused on non-neovascular lesions of macular degeneration. The Age-Related Eye Disease (AREDS) study reported good to excellent inter-rater reliability and reproducibility using colour photography to identify characteristics of advanced AMD.…”

Section: Discussionmentioning

confidence: 99%

An evaluation of photographic screening for neovascular age-related macular degeneration

Maberley

Isbister

Mackenzie

et al. 2004

Eye

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Background Photographic screening for neovascular age-related macular degeneration (AMD) is not commonly employed because the prevalence of treatable disease is low and fluorescein angiography is considered necessary for the diagnosis of this form of AMD. However, there may be a role for colour retinal imaging in assisting with the diagnosis and triage of subjects with neovascular AMD. The purpose of this study was to evaluate the utility of colour fundus photographs for identifying subjects with potentially treatable neovascular AMD. Methods A total of 74 stereo pairs of Kodachrome colour slides of subjects with AMD were evaluated (i) nonstereoscopically, (ii) stereoscopically, and (iii) stereoscopically with visual acuity and visual symptom data. Two retina specialists read the images to identify active exudative lesions. Results The kappa statistic comparing the retinal specialists diagnosis of treatable neovascular AMD from color slides was excellent. The sensitivity and specificity of nonstereo images for the appropriate categorization of lesions was 0.95 and 0.90 respectively. The evaluation of stereo pairs was more sensitive, but less specific, 0.98, 0.83, as was the evaluation of stereo-pairs with clinical histories and visual acuities, 1.00, 0.77. Conclusions The evaluation of colour images for subjects with suspected exudative macular degeneration can be diagnostic for neovascular AMD and may expedite the appropriate referral of patients for more timely angiography and treatment. Incorporating more clinical information for the image evaluators ((i) stereo image pairs and/or (ii) presenting symptomatology and visual acuity

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“…20 Late ARM was defined to include the two end-stage lesions, geographic atrophy and neovascular maculopathy. Early ARM was defined as the absence of late ARM and either (1) large (4125 mm) indistinct soft drusen or reticular drusen, or (2) both large soft distinct drusen and retinal pigment epithelial (RPE) abnormalities (hyper-or hypopigmentation), within the superimposed grading grid.…”

Section: Methodsmentioning

confidence: 99%

Early age-related maculopathy in eyes after cataract surgery

Pham

Cugati

Rochtchina

et al. 2006

Eye

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Purpose To assess age-related maculopathy (ARM) in eyes of patients who had undergone cataract surgery for at least a year. Methods Consecutive patients aged 60 þ years who had undergone cataract surgery at Westmead Hospital, Sydney, Australia, during 2001-2003 were examined in 2004. Interview using standardized questionnaires and stereo retinal photography was performed. Retinal photographs were graded using the Wisconsin ARM grading system. The proportions with ARM were compared between surgical and nonsurgical eyes, and between this surgical cohort and the Blue Mountains Eye Study (BMES) population. Results Of the 622 eligible patients, 454 (73%) were re-examined, with a mean followperiod of 2.8 years. Surgical eyes had a higher proportion of early ARM compared to nonsurgical eyes (15.2 vs 10.3%, P ¼ 0.07) and to the early ARM prevalence found in BMES participants of similar age (14.5 vs 6.9%, Po0.01), which persisted after age standardization to the BMES population (9.7 vs 6.9%, Po0.05). Conclusions We found an increased prevalence of early ARM in surgical eyes of patients 1-3 years after cataract surgery. Whether this increased early ARM prevalence leads to an increased prevalence of late ARM in the long-term warrants further investigation.

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The Wisconsin Age-related Maculopathy Grading System

Cited by 1,034 publications

References 18 publications

Dyslipidaemia and microvascular disease in the retina

Dyslipidaemia and microvascular disease in the retina

An evaluation of photographic screening for neovascular age-related macular degeneration

Early age-related maculopathy in eyes after cataract surgery

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