Change in area of geographic atrophy in the Age-Related Eye Disease Study: AREDS report number 26.
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.
Lindblad
Anne S
AS
Lloyd
Patricia C
PC
Clemons
Traci E
TE
Gensler
Gary R
GR
Ferris
Frederick L
FL
Klein
Michael L
ML
Armstrong
Jane R
JR
D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000627:therapeutic use; D001284:Atrophy / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D020256:Choroidal Neovascularization / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D003300:Copper / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010781:Photography; D011446:Prospective Studies; D055213:Retinal Pigment Epithelium / Q000187:drug effects / Q000473:pathology*; D014786:Vision Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology; D015034:Zinc Oxide / Q000627:therapeutic use
D000975:Antioxidants; D003300:Copper; D015034:Zinc Oxide; C030973:cupric oxide