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Randomized Controlled Trial
. 2009 Sep;127(9):1168-74.
doi: 10.1001/archophthalmol.2009.198.

Change in area of geographic atrophy in the Age-Related Eye Disease Study: AREDS report number 26

Anne S Lindblad, Patricia C Lloyd, Traci E Clemons, Gary R Gensler, Frederick L Ferris 3rd, Michael L Klein, Jane R Armstrong; Age-Related Eye Disease Study Research Group
Collaborators
Randomized Controlled Trial

Change in area of geographic atrophy in the Age-Related Eye Disease Study: AREDS report number 26

Anne S Lindblad et al. Arch Ophthalmol. 2009 Sep.

Abstract

Objective: To characterize progression of geographic atrophy (GA) associated with age-related macular degeneration in AREDS as measured by digitized fundus photographs.

Methods: Fundus photographs from 181 of 4757 AREDS participants with a GA area of at least 0.5 disc areas at baseline or from participants who developed bilateral GA during follow-up were scanned, digitized, and evaluated longitudinally. Geographic atrophy area was determined using planimetry. Rates of progression from noncentral to central GA and of vision loss following development of central GA included the entire AREDS cohort.

Results: Median initial lesion size was 4.3 mm(2). Average change in digital area of GA from baseline was 2.03 mm(2) (standard error of the mean, 0.24 mm(2)) at 1 year, 3.78 mm(2) (0.24 mm(2)) at 2 years, 5.93 mm(2) (0.34 mm(2)) at 3 years, and 1.78 mm(2) (0.086 mm(2)) per year overall. Median time to developing central GA after any GA diagnosis was 2.5 years (95% confidence interval, 2.0-3.0). Average visual acuity decreased by 3.7 letters at first documentation of central GA, and by 22 letters at year 5.

Conclusions: Growth of GA area can be reliably measured using standard fundus photographs that are digitized and subsequently graded at a reading center. Development of GA is associated with subsequent further growth of GA, development of central GA, and loss in central vision.

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Figures

Figure 1.
Figure 1.
Example of geographic atrophy area. Geographic atrophy is defined by 3 criteria: presence of a circular shape; presence of a sharp well-demarcated edge; and diminished retinal pigment epithelium pigment (partial or complete depigmentation of the retinal pigment epithelium, typically with exposure of underlying choroidal blood vessels). A, Geographic atrophy area equals 5.33 mm2. B, Geographic atrophy area equals 8.23 mm2.
Figure 2.
Figure 2.
Bland/Altman plot comparing 2 reading centers. The solid horizontal line is the overall average area. Dotted horizontal lines include 95% of the data. Difference is first center minus second center.
Figure 3.
Figure 3.
Mean geographic atrophy growth by baseline lesion size. Error bars indicate ±1 SEM.
Figure 4.
Figure 4.
Bilateral geographic atrophy growth.
Figure 5.
Figure 5.
Mean visual acuity over time following development of central geographic atrophy. The small dots indicate 95% confidence intervals.
See this image and copyright information in PMC

References

    1. Friedman DS, O’Colmain BJ, Muñoz B, et al.; Eye Diseases Prevalence Research Group. Prevalence of age-related macular degeneration in the United States. Arch Ophthalmol. 2004;122(4):564–572. - PubMed
    1. Lindblad AS, Clemons TE; Age-Related Eye Disease Study Research Group. Responsiveness of the National Eye Institute Visual Function Questionnaire to progression to advanced age-related macular degeneration, vision loss and lens opacity. AREDS Report No. 14. Arch Ophthalmol. 2005;123(9):1207–1214. - PMC - PubMed
    1. Sunness JS, Gonzalez-Baron J, Applegate CA, et al. Enlargement of atrophy and visual acuity loss in the geographic atrophy form of age-related macular degeneration. Ophthalmology. 1999;106(9):1768–1779. - PubMed
    1. Bellmann C, Jorzik J, Spital G, Unnebrink K, Pauleikhoff D, Holz FG. Symmetry of bilateral lesions in geographic atrophy in patients with age-related macular degeneration. Arch Ophthalmol. 2002;120(5):579–584. - PubMed
    1. Sunness JS, Applegate CA, Bressler NM, Hawkins BS Designing clinical trials for age-related geographic atrophy of the macula: enrollment data from the geographic atrophy natural history study. Retina. 2007;27(2):204–210. - PubMed

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