Developing prognostic biomarkers in intermediate age‐related macular degeneration: their clinical use in predicting progression

Abstract

Age‐related macular degeneration is a common, complex and blinding eye disease. When early and intermediate levels of severity are detected in one or both eyes, there is a wide‐ranging 0.4 to 53 per cent risk of progression to advanced disease in five years. In order to maximise visual outcomes for their patients, practising eye‐care professionals must be able to stratify patients according to their risk of progression, intervene (for example by recommending smoking cessation or nutritional supplements and Amsler grid self‐monitoring in intermediate disease) and monitor accordingly. With the aid of ocular imaging, a range of under‐recognised yet meaningful risk factors have been identified. The purpose of this review is to assist the eye‐care practitioner in stratifying the risk of progression in intermediate age‐related macular degeneration using the range of established and emerging precursory signs that herald loss of vision.

Key words:

• age‐related macular degeneration
• disease staging
• prognosis
• progression

ACKNOWLEDGEMENTS

The authors thank Tyson Xu for his assistance in the literature search and for identifying the case images. This work was supported, in part, by grants and awards from the University of New South Wales (Early Career Research Grant 2015–2016 #P535430, an Australian Postgraduate Award), and a National Health and Medical Research Council (NHMRC) grant (#1033224). Guide Dogs NSW/ACT is a partner in the NHMRC grant and also provided a supplementary PhD scholarship for AL and support for LN‐S.

Additional information

Funding

National Health and Medical Research Council (NHMRC)

University of New South Wales