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Title: Age-Related Macular Degeneration Staging by Color Fundus Photography vs. Multimodal Imaging-Epidemiological Implications (The Coimbra Eye Study-Report 6)
Authors: Farinha, Cláudia 
Cachulo, Maria da Luz 
Coimbra, Rita 
Alves, Dalila 
Nunes, Sandrina 
Pires, Isabel 
Marques, João Pedro 
Costa, José 
Martins, Amélia 
Sobral, Isa 
Barreto, Patrícia 
Laíns, Inês 
Figueira, João 
Ribeiro, Luísa 
Cunha-Vaz, José 
Silva, Rufino 
Keywords: age-related macular degeneration; AMD staging; multimodal Imaging; early AMD; late AMD
Issue Date: 2-May-2020
Publisher: MDPI
Project: Novartis 
Serial title, monograph or event: Journal of Clinical Medicine
Volume: 9
Issue: 5
Abstract: Epidemiology of age-related macular degeneration (AMD) is based on staging systems relying on color fundus photography (CFP). We aim to compare AMD staging using CFP to multimodal imaging with optical coherence tomography (OCT), infra-red (IR), and fundus autofluorescence (FAF), in a large cohort from the Epidemiologic AMD Coimbra Eye Study. All imaging exams from the participants of this population-based study were classified by a central reading center. CFP images were graded according to the International Classification and Grading System for AMD and staged with Rotterdam classification. Afterward, CFP images were reviewed with OCT, IR, and FAF and stage update was performed if necessary. Early and late AMD prevalence was compared in a total of 1616 included subjects. In CFP-based grading, the prevalence was 14.11% for early AMD (n = 228) and 1.05% (n = 17) for late AMD, nine cases (0.56%) had neovascular AMD (nAMD) and eight (0.50%) geographic atrophy (GA). Using multimodal grading, the prevalence increased to 14.60% for early AMD (n = 236) and 1.61% (n = 26) for late AMD, with 14 cases (0.87%) of nAMD and 12 (0.74%) of GA. AMD staging was more accurate with the multimodal approach and this was especially relevant for late AMD. We propose that multimodal imaging should be adopted in the future to better estimate and compare epidemiological data in different populations.
ISSN: 2077-0383
DOI: 10.3390/jcm9051329
Rights: openAccess
Appears in Collections:FMUC Medicina - Artigos em Revistas Internacionais
I&D ICBR - Artigos em Revistas Internacionais
I&D CIBIT - Artigos em Revistas Internacionais

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