Researchers establish expanded algorithm for advanced AMD risk prediction

Ophthalmology. 2011;118(11):2203-2211.

Age, body mass index, smoking status, genetic variations, pre-existing retinal disease and drusen size strongly correlated with an elevated risk of progression to advanced age-related macular degeneration, a large study found.

Researchers then used these factors to establish an expanded algorithm for risk prediction.

"The algorithms could be very useful for identifying high-risk individuals for future clinical trials designed to evaluate new treatments," the study authors said.

The prospective, longitudinal study included 2,937 subjects who participated in the Age-Related Eye Disease Study.

Investigators calculated hazard ratios for progression to advanced AMD, devised statistical models to differentiate subjects who progressed and those who did not progress, and subdivided the overall model into derivation and test models.

In the study, 819 subjects progressed to advanced AMD. Data showed that 265 subjects progressed to geographic atrophy but not neovascularization; 379 subjects progressed to neovascularization in one eye but did not progress to geographic atrophy; and 175 subjects progressed to geographic atrophy in one eye and neovascularization in the other eye.

At baseline, mean age of subjects who progressed to advanced AMD was 70.2 years and mean age of those who did not progress was 68.1 years. Average follow-up was 9.2 years for subjects with no advanced AMD and 6.7 years for those with advanced disease in one eye.

Subjects who progressed were older, less educated, more likely to be current or former smokers, and had higher body mass index than those who did not progress. All six genetic variants were significantly related to progression to advanced AMD, the authors said.