This longitudinal study used ultra-widefield (UWF) imaging to examine peripheral retinal abnormalities in age-related macular degeneration (AMD) over 5 years. The study included 265 eyes from 137 participants in the OPERA ancillary study of AREDS2. UWF color and autofluorescence images were taken at years 5 and 10 and graded for macular and peripheral AMD features using a 3-zone grid.
Key findings:
– In the central zone (zone 1), AMD severity increased over time, with advanced AMD (geographic atrophy or neovascular AMD) increasing from 43% to 64% of eyes.
– Peripheral AMD features in zone 2 were common and stable, including drusen (99% at both timepoints), hyperpigmentation (11%), and hypopigmentation (4-7%).
– Non-AMD peripheral changes increased, including cobblestone degeneration (19% to 30%) and reticular pigmentary changes (25% to 33%).
– Progression to advanced AMD was similar in eyes with and without significant peripheral findings (41%).
– In autofluorescence, reticular patterns increased from 22% to 39% of eyes, with 5-6% most prominent outside zone 1.
– Geographic atrophy prevalence increased from 53 to 91 eyes, with mean area increasing from 3.4 mm² to 7.7 mm².
The study concludes that AMD features often extend beyond the macula, suggesting it is a pan-retinal disease. However, peripheral findings were not associated with increased risk of progression to advanced AMD in this cohort. These results provide new longitudinal data on the prevalence and progression of peripheral retinal changes in AMD using advanced wide-field imaging technology.”
Froines, Colin P., et al. “Longitudinal Assessment of AMD using Ultrawide Field Imaging – The Optos PEripheral RetinA (OPERA) Follow-up Study.” Ophthalmology, vol. S0161-6420, no. 24, 29 Nov. 2024, pp. 00749-8.