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. 2022 Jun 1;11(6):23.
doi: 10.1167/tvst.11.6.23.

A Screening Tool for Self-Evaluation of Risk for Age-Related Macular Degeneration: Validation in a Spanish Population

Alfredo García-Layana  1   2   3 , Maribel López-Gálvez  3   4   5   6 , José García-Arumí  7 , Luis Arias  8 , Alfredo Gea-Sánchez  9 , Juan J Marín-Méndez  10 , Onintza Sayar-Beristain  11 , Germán Sedano-Gil  11 , Tariq M Aslam  12 , Angelo M Minnella  13 , Isabel López Ibáñez  14 , José M de Dios Hernández  15 , Johanna M Seddon  16
Affiliations

A Screening Tool for Self-Evaluation of Risk for Age-Related Macular Degeneration: Validation in a Spanish Population

Alfredo García-Layana et al. Transl Vis Sci Technol. .

Abstract

Purpose: The objectives of this study were the creation and validation of a screening tool for age-related macular degeneration (AMD) for routine assessment by primary care physicians, ophthalmologists, other healthcare professionals, and the general population.

Methods: A simple, self-administered questionnaire (Simplified Théa AMD Risk-Assessment Scale [STARS] version 4.0) which included well-established risk factors for AMD, such as family history, smoking, and dietary factors, was administered to patients during ophthalmology visits. A fundus examination was performed to determine presence of large soft drusen, pigmentary abnormalities, or late AMD. Based on data from the questionnaire and the clinical examination, predictive models were developed to estimate probability of the Age-Related Eye Disease Study (AREDS) score (categorized as low risk/high risk). The models were evaluated by area under the receiving operating characteristic curve analysis.

Results: A total of 3854 subjects completed the questionnaire and underwent a fundus examination. Early/intermediate and late AMD were detected in 15.9% and 23.8% of the patients, respectively. A predictive model was developed with training, validation, and test datasets. The model in the test set had an area under the curve of 0.745 (95% confidence interval [CI] = 0.705-0.784), a positive predictive value of 0.500 (95% CI = 0.449-0.557), and a negative predictive value of 0.810 (95% CI = 0.770-0.844).

Conclusions: The STARS questionnaire version 4.0 and the model identify patients at high risk of developing late AMD.

Translational relevance: The screening instrument described could be useful to evaluate the risk of late AMD in patients >55 years without having an eye examination, which could lead to more timely referrals and encourage lifestyle changes.

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Conflict of interest statement

Disclosure: A. García-Layana, Allergan (C), Bayer (C), Novartis (C), Roche (C), and Théa Laboratoires (C); M. López-Gálvez, Allergan (C), Roche (C), Novartis (C), Bayer (C), and Ferrer (C); J. García-Arumí, Allergan (C), Bayer (C), Novartis (C), and Roche (C); L. Arias, Allergan (C), Bayer (C), Novartis (C), Roche (C), and Topcon (C); A. Gea-Sánchez, None; J.J. Marín-Méndez, None; O. Sayar-Beristain, None; G. Sedano-Gil, None; T.M. Aslam, Bayer (C), Théa Laboratoires (C), Allergan (C), Novartis (C), and Roche (C); A.M. Minnella, Théa Laboratoires (C); I.L. Ibáñez, None; J.M. de Dios Hernández, None; J.M. Seddon, Scientific Co-Founder and equity in Gemini Therapeutics, Inc; equity in Apellis Pharmaceuticals; Théa Laboratoires (C)

Figures

Figure 1.
Figure 1.
Area under ROC (AUC) curve of the logistic regression model derived from the test set.
Figure 2.
Figure 2.
Relationship between the logistic regression model probabilities and the AREDS score's associated probabilities (Table 3).
See this image and copyright information in PMC

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