Age-related Macular Degeneration Phenotype Consensus Meeting
Table 1: Comparing color photographs grading
AREDS |
Beaver Dam |
Blue Mountains |
CAPT |
Melbourne |
MEH |
Rotterdam |
Wilmer Eye Institute | |
---|---|---|---|---|---|---|---|---|
Quality |
Good Fair Borderline/Poor Explained/unexplained Focus/Field/Stereo/Other |
Good Fair Borderline/Poor Explained/unexplained Focus/Field/Stereo/Other |
Gradable/ungradeable/ Not present Good/fair/poor for Focus/Field/Stereo |
1, Good 2, fair 3, poor 4, missing |
Focus – field- stereo Good – fair – poor NO MISSING on grading form |
1-5: perfect – not gradable 9: Missing |
Focus – field Good – fair – cannot grade Reasons given |
Focus – field- stereo Adequate Fair- poor Missing |
Measuring tools |
C0-2: size I1-2; O1-2:� area |
C0-2: size I1-2; O1-2:� area |
C0-2: size I1-2; O1-2:� area |
C0 (63 μ) C1 (125 μ) C2 (250 μ) |
C0- C4: 63 μ; 125 μ; 175 μ; 250 μ; 500 μ circles |
C0-C4: 63 μ; 125 μ; 175 μ; 250 μ; 500 μ circles |
C0-C2: 63 μ; 125 μ; 250 μ circles C2 = 250 μ |
C0, C1, C2 for fellow eye Drusen for most advanced AMD MPS for FFA |
Double grading |
Yes: Preliminary and detailed |
Yes: Preliminary and detailed and edit (and longitudinal regrades for incidence) |
No Open adjudication Side-by-side grading for F/U |
Yes, with open adjudication Senior grader might grade some images alone |
No Side-by-side grading for F/U Collate clinical result with grading for observational studies |
Yes, with open adjudication Senior grader might grade some images alone |
YES |
Yes with review |
Grading rules |
<50% Not present 51-90% Q >90% Present |
SAME |
SAME |
SAME |
Does not use category of Questionable |
SAME |
SAME |
SAME |
Grid used |
500 μ -1500 μ -3000 μ radius 9 fields |
SAME
9 fields |
SAME
3 fields |
SAME
3 fields |
SAME
3 fields |
SAME
3 fields |
SAME
3 fields |
SAME |
Number of fields taken |
3 stereo fields: Fields 1M, 2, 3M |
3 fields: Fields 1-3, plus iris |
7 fields, disc and macula stereo |
Stereo Fields 1-2 at baseline then Field 2 |
Field 2: up until 2002 stereo film Currently in the process of evaluating digital |
Usually Field 2: Centred on the macula |
35 degree field of the macula |
Stereo fields 1+2 |
Drusen grading protocol based on: |
Wisconsin |
Wisconsin |
Wisconsin |
International |
International |
International |
International |
Wisconsin |
|
Estimate max. size |
Estimate max. size |
Estimate max. size |
|
|
|
|
Est.max.size |
<63 μ |
C0 |
<C0 |
C0 |
C0 |
C0 |
C0 |
C0 |
C0 |
63-125 μ |
C1 |
C0 - <C1 |
C1 |
C1 |
C0-C1 |
C1 |
C1 |
C1 |
125-250 μ |
C1 – C2 |
C1 – <C2 |
C2 |
C2 (250 μ) |
C1-C2 and C2 – C3 |
C1 – C3 |
C2 |
>125 |
250-500 μ |
C2 |
≥C2 |
≥C2 |
>C2 |
>C3 |
C3 – C4 |
|
No |
>500 μ |
No |
No |
No |
|
No |
> C4 |
|
No |
Number |
Only record area covered by drusen |
Same as AREDS |
<10;� ≥10 |
Only >125 μ
<10; 10-20, >20 |
Total number by type of Drusen: Q; 1-9; 10-19; ≥ 20 |
1-9, 10-19; 20- 50; >50 |
In grid-outside grid; size C0; C1; C2
0; 0-10, <20; >20 |
Any size: 1-4; 5-19; 20 or more |
Confluency |
Soft distinct Soft indistinct |
Hard distinct Hard indistinct Soft distinct Soft indistinct In all subfields Plus measure longest continuous |
Soft distinct Soft indistinct |
None <10 pairs ≥10 pairs |
Soft distinct Soft indistinct Within grid |
Per circle per drusen |
0, Q or <10% <50% >50% |
In pairs: No/Q/<10; ≥10 |
Area |
None/Q/<C0 <C1; <C2; <I2; <O2; <Half DD; <1DD; >1DD, CG |
Per subfields: NA/<C0 <C1; 2xC1; <C2; <2C2, <4C2; <50%; >50% Global area: None/Q/<C0 <C1; <C2; <I2; <O2; |
None/Q/<C0 <C1; <C2; <I2; <O2; <Half DA; <1DA; ≥1DA, CG
|
None/<10CAPT drusen; <10%; 10-25%; ≥25-50%; ≥50% |
Fovea - 3 fields: central-middle – outer – outside grid <10% <25%; <50%; ≥50% |
central-middle – outer circle <10% <25%; <50%; ≥50% |
central-middle – outer circle <1%; <10% <25%; <50% ≥50% |
<10%. 11-33%; 34-67%; >67% |
Reticular Drusen |
No/Q/Outside grid/Within and outside grid/CG |
Yes, in all subfields |
No/Q/Outside grid/Within and outside grid/CG |
Yes: within or outside grid |
No |
No |
Yes |
Yes |
Calcified/ Crystalline Drusen |
No/Q/Outside grid/Within and outside grid/CG |
Yes – global list |
No/Q/Outside grid/Within and outside grid/CG |
No |
Yes |
Yes |
No |
No |
Hyperpigmentation Absent/ present |
Yes |
Yes/No/Cannot grade |
Yes |
Yes |
Absent/present Max size ≥C0 <C1 ≥C1 <C2 ≥C2 <C3 ≥C3 |
Yes: Punctate Linear Mixed |
Absent Q or outside grid <C1 <C2 ≥C2 |
Yes: <St 2 ≥St 2
|
Area |
None/Q/ <I2; <O2; <1/2 DA; <1DA; <2DA; ≥2DA |
Per subfields: <C1; <C2; ≥C2 Global: <C0; <C1; <C2; ≥C2
|
None/Q/<C0 <C1; <C2; <O2; ≥O2; CG |
No/Q/ <250 μ (C2) ≥250 μ |
Fovea = 3 fields <10%; <25%, <50%, >50% |
≤C0 >C0 |
NO |
|
Hypopigmen tation/RPE depigmentation |
Yes |
Yes/No/Cannot grade |
Yes |
Yes |
Absent/present Max size ≥C0 <C1 ≥C1 <C2 ≥C2 <C3 ≥C3 |
Yes |
Absent Q or outside grid <C1 <C2 ≥C2 |
<Std 4 ≥Std4 |
Area |
None/Q/ <I2; <O2; <1/2 DA; <1DA; <2DA; ≥2DA |
Per subfields: <C2; <25%; <50%; ≥50% Global: <C2; <O2; ≥O2
|
None/Q/<I1; <O2; <Half DA; <1DA; <2DA, ≥2DA; CG |
No/Q or <250 μ; ≥250 μ� –≤1DA; >1DA -≤ 2DA, >2DA |
Fovea = 3 fields <10%; <25%, <50%, >50% |
≤C0 >C0 |
NO |
NO |
GA definition
|
Min 2 out of 3 of these: Circular in shape, sharp borders, visibility of choroidal vessels |
SAME |
SAME |
SAME |
SAME |
SAME |
SAME |
Std 3 |
GA minimum area |
I2 |
I1 (≥175 μ) |
|
Present: >250 |
C2 |
≥175 μ |
>175 μ |
Standard 3 |
Centre point involved indicated |
Yes |
Yes |
Yes |
No |
Yes: Fovea� 3 fields: central-middle – outer – outside grid |
No |
No |
Yes |
GA Size |
None/Q/ <I2; <O2; <1/2 DA; <1DA; <2DA; ≥2DA |
Per subfields: Per subfields: <25%; <50%; ≥50% |
None/Q/<I1; <O2; <Half DA; <1DA; <2DA, ≥2DA; CG |
No/Q or <250 μ ≥250 – <1 MPS DA; ≥1 MPS DA - <2DA, ≥2 MPS DA |
≥C2 - <C3 ≥C3 - <C4 ≥C3- <1000 μ ≥1000 - <3000μ ≥3000 - <6000μ |
≥C2 - <C3 ≥C3 - <C4 ≥C3- <1000 μ ≥1000 - <3000μ ≥3000 - <6000μ ≥6000 |
Per fields: Q; <25%; <50%; ≥50% |
<Std 3 ≥Std 3 |
Neovascular AMD |
Yes |
Yes No/Q/PED ≥90%; Mixed; RD ≥90% |
Same as AREDS |
Graded as Exudative event on FFA |
Yes |
Yes, by circle |
Yes |
Yes |
Fovea involved |
No |
Yes |
No |
N/A |
Yes |
No |
NO |
Yes |
Area |
Within Field 2 in DA |
Within Field 2 in DA |
Within Field 2 in DA |
N/A |
By feature ≥C2 - <C3 ≥C3 - <C4 ≥C3- <1000 μ ≥1000 - <3000μ ≥3000 - <6000μ |
Total area ≥C2 - <C3 ≥C3 - <C4 ≥C3- <1000 μ ≥1000 - <3000μ ≥3000 - <6000μ ≥6000 |
Per fields of the whole lesion: Q; <25%; <50%; ≥50% |
No |
Serous detachment |
Yes |
No? |
Yes/with Haem RD |
N/A |
Yes |
Yes |
No/Q/Present |
No/Q/Yes |
Subret haemorrhage |
Yes/ with SubRPE haem |
Yes, per subfields |
Yes/ with SubRPE haem |
N/A |
|
Yes |
No/Q/Present |
|
Fibrous scar |
Yes |
Yes, per subfields |
Yes |
N/A |
Yes |
Yes |
No/Q/Present |
Yes: disciform or laser |
Hard exudates |
Yes |
Yes |
Yes |
N/A |
Yes |
Yes |
No/Q/Present |
No/Q/Yes |
Haem neuroretinal detachement |
Yes |
No? |
Yes/with Serous RD |
N/A |
Yes |
Ye |
No |
No/Q/Yes |
Serous RPE detachment |
Yes |
No |
Yes (non-drusenoid RD) |
N/A |
Yes |
Yes |
No |
Yes |
Drusenoid detachment |
Yes |
No |
Yes |
N/A |
Yes |
Sero-granular Drusen |
No |
Yes, foveal or not |
Haem RPE detachment |
Yes |
No? |
Yes/with Serous RD |
N/A |
Yes |
Yes |
No |
|
Retinal haem |
No |
Yes |
No |
N/A |
Yes |
Yes |
No |
No/Q/Yes |
Subhyloid haem |
No |
Yes |
No |
N/A |
Yes |
Yes |
No |
|
Intravitreal haem |
No |
Yes |
No |
N/A |
Yes |
Yes |
No |
|
|
Wisconsin: MPS Protocol used |
CAPT |
MEH |
Wilmer Eye Institute: several studies are graded on FFA |
---|---|---|---|---|
Quality |
Good Fair Borderline/Poor Explained/unexplained Focus/Field/Stereo/Other |
1, Good 2, fair 3, poor 4, missing Focus/clarity/stereopsis |
1-5: perfect – not gradable 9: Missing |
Focus – field- stereo Adequate Fair- poor Missing |
Number of fields taken |
Stereo pairs of macula
|
Stereo pairs of macula |
Field 2: Centred on the macula Not necessarily stereo |
|
Evidence of neovascular event |
Yes/No |
Yes/No Cannot grade |
Yes/No |
|
CNV |
No CNV/Classic/Occult/Classic plus occult/Scar only |
No CNV/Classic/Occult/Classic plus occult/Scar only |
Yes/No Percentage of classic |
No Percentage of classic lesion Occult present |
S-PED |
|
No S-PED; S-PED <1DA; ≥1DA; CD size |
Yes/No |
Yes/No |
Blood obscures CNV border |
|
Yes/no |
|
Yes/No |
EBF obscures CNV border |
|
Yes/no |
|
|
Blood >50% of lesion |
|
Yes/no |
|
Yes/No |
Other blood in fovea |
|
Yes/no |
|
|
Fovea involved |
|
Yes/no |
No |
|
Component in FAZ |
|
Not subfoveal/CNV, Blood, EBF, S-PED, style="mso-spacerun: yes">� Scar |
|
Yes: laser scar, blocked fluorescence; feeder vessel |
Lesion entirely well demarcated |
|
Yes/no |
|
|
Size of the lesion |
|
≤1DA; ≤2DA; ≤3.5DA; ≤6DA; ≤9DA; ≤12DA; >12 |
≥C2 <C3;� ≥C3 <C4 ≥C3 <1000;� ≥1000<3000 ≥3000<6000; ≥6000 |
≤1DA; ≤2DA; ≤3.5DA; ≤6DA; ≤9DA; ≤12DA; ≤16DA >16 |
Evidence of previous laser |
|
On F/U |
No |
|
Non-peripheral leakage |
|
|
No |
Yes/No |
Drusen grading |
|
|
Detailed grading for size and hyperfluorescence |
Yes/No |
GA |
|
|
Presence plus area |
|