Clinical Stage of Dry Age-Related Macular Degeneration Impacts Progression

Senile Macular Degeneration
Retinal Fluorescein Angiogram Of Age Related Macular Degeneration. (Photo By BSIP/UIG Via Getty Images)
Researchers retrospectively analyzed data of 645,815 patients to determine 1-year transition probabilities.

This article is part of Ophthalmology Advisor’s Focus on Retina coverage from the 2021 meeting of the American Academy of Ophthalmology, held in New Orleans from November 12 to 15, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the retinal experts at the AAO. Check back for more from the AAO 2021 Meeting.


The progression rate of age-related macular degeneration (AMD) reflects its current clinical stage, according to research presented at the American Academy of Ophthalmology 2021 Annual Meeting held in New Orleans.

The objective of the study was to analyze prevalence of visual impairment and assess AMD progression in adult patients with dry AMD.

The researcher reviewed the medical records of 645,815 patients (mean age 76 years, 62% women) with nonexudative, or “dry,” AMD who participated in the IRIS Registry from 2016 to 2019. Visual acuity was measured before diagnosis of each patient.

In the cohort, 59% of patients had early dry AMD (stage 1), 27% had intermediate dry AMD (S2), 3% had geographic atrophy (GA) without (S3) or with (S4) subfoveal involvement, and 8% had unspecified dry AMD. Most patients in stages 1 through 3 (88.4%, 79.7%, 57.1%, respectively) tended to have visual acuity (VA) of at least 20/63 in the eye included in the study. Early Treatment Diabetic Retinopathy Study (ETDRS) scores decreased in the various stages, from 71.0±13.3 in S1 to 66.6±16.0 in S2 to 53.7±25.2 in S3 to 38.7±26.0 in S4.

Baseline visual acuity deteriorated as dry AMD progressed, researchers found through regression modeling.

The researchers found that, after 1 year, 87.2% of patients with S1, 86.4% of patients with S2, 82.1% of patients with S3, and 92.3% of patients with S4 maintained dry AMD stage. Progression to GA after 1 year was 0.4% likely in S1, 8.0% in S2, 6.9% in S3 and 7.7% in S4 while the probability for those with dry AMD to develop wet AMD after 1 year was 0.5% for S1, 8.0% for S2, 6.9% for S3, and 7.7% for S4.

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Leng T. A real-world study of prevalence and natural history disease progression among adults with dry AMD in the IRIS registry. Presented at: American Academy of Ophthalmology 2021 Annual Meeting; November 12-15; New Orleans. Abstract PO052.