title: Validating the AREDS Simplified Severity Scale of Age-Related Macular Degeneration with 5- and 10-Year Incident Data in a Population-Based Sample.
abstract: Most classification systems for age-related macular degeneration (AMD) were developed from patients in clinical trials. We aimed to validate the Age-Related Eye Diseases Study (AREDS) simplified severity scale of AMD classification using 5- and 10-year incident late AMD data from the population-based Blue Mountains Eye Study (BMES) cohort.
  
  
  
  Comparative study of population-based cohort and clinical trial.
  
  
  
  Blue Mountains Eye Study participants 40 to 97 years of age at baseline (n = 2134) and AREDS participants 55 to 80 years of age (n = 3640).
  
  
  
  In the BMES, AMD lesions were graded from stereoscopic color photographs and were classified according to the AREDS simplified severity scale. The AREDS simplified scale calculates a risk score based on the number of early AMD risk factors (large drusen and pigment abnormalities) in both eyes that can range from 0 to 4.
  
  
  
  Five- and 10-year incident late AMD (presence of geographic atrophy or choroidal neovascularization).
  
  
  
  The AREDS simplified scale performed similarly when applied to both the BMES population-based participants and the AREDS clinical trial-based participants in predicting 5- and 10-year incidence of late AMD. For scores 0 to 4, the 5-year incidence rates for the BMES compared with the AREDS were 0.2% versus 0.4%, 3.1% versus 3.1%, 12.1% versus 11.8%, 13.5% versus 25.9%, and 47.1% versus 47.3%, respectively. The corresponding 10-year incidence rates for the BMES compared with the AREDS were 0.7% versus 1.5%, 7.3% versus 8.4%, 36.6% versus 27.6%, 20.0% versus 52.7%, and 75.0% versus 71.4%, respectively.
  
  
  
  The AREDS simplified severity scale classified late AMD risk levels similarly when applied to population-based and clinical trial samples. These results support the robustness of the AREDS simplified severity scale.
authors.affiliation: Centre for Vision Research, Department of Ophthalmology, Westmead Hospital, the Westmead Millennium Institute for Medical Research, University of Sydney, Sydney, Australia. Electronic address: gerald.liew@sydney.edu.au.
authors.forename: Gerald
authors.initials: G
authors.lastname: Liew
authors.affiliation: Centre for Vision Research, Department of Ophthalmology, Westmead Hospital, the Westmead Millennium Institute for Medical Research, University of Sydney, Sydney, Australia.
authors.forename: Nichole
authors.initials: N
authors.lastname: Joachim
authors.affiliation: Centre for Vision Research, Department of Ophthalmology, Westmead Hospital, the Westmead Millennium Institute for Medical Research, University of Sydney, Sydney, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.affiliation: Centre for Vision Research, Department of Ophthalmology, Westmead Hospital, the Westmead Millennium Institute for Medical Research, University of Sydney, Sydney, Australia.
authors.forename: George
authors.initials: G
authors.lastname: Burlutsky
authors.affiliation: Centre for Vision Research, Department of Ophthalmology, Westmead Hospital, the Westmead Millennium Institute for Medical Research, University of Sydney, Sydney, Australia.
authors.forename: Jie Jin
authors.initials: JJ
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D020256:Choroidal Neovascularization / Q000175:diagnosis; D005500:Follow-Up Studies; D057092:Geographic Atrophy / Q000175:diagnosis; D006801:Humans; D015994:Incidence; D008268:Macular Degeneration / Q000145:classification* / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015593:Retinal Drusen / Q000175:diagnosis; D012307:Risk Factors; D012720:Severity of Illness Index