Trockene altersabhängige Makuladegeneration – Epidemiologie und Klassifikation

Zusammenfassung

Klinisch wird die altersabhängige Makuladegeneration (AMD) in Früh- und Spätstadien eingeteilt. Der Begriff „trockene“ AMD wird häufig verwendet, wenn keine „exsudativen“ Veränderungen am Augenhintergrund vorliegen. Es existiert eine Vielzahl von Studien zur Epidemiologie der AMD. Dabei wird in den meisten Studien zwischen AMD-Früh- und -Spätformen unterschieden, allerdings ohne eine weitere Differenzierung der „trockenen“ AMD-Spätform. Zudem stellt sich die Herausforderung unterschiedlicher Klassifikationen der AMD in verschiedenen Studien, was zwangsläufig zu Abweichungen in den epidemiologischen Daten bei der AMD führt. Neue Klassifikationssysteme berücksichtigen mikrostrukturelle Veränderungen, die mittels hochauflösender In-vivo-Bildgebung der Netzhaut detektiert werden können. Eine neue Konsensusklassifikation der AMD-assoziierten Atrophie soll ermöglichen, zukünftige Studien nach einheitlichen Definitionen durchzuführen.

Abstract

Age-related macular degeneration (AMD) is clinically divided into early and late stages. The term “dry” AMD is widely used when there are no “exudative” changes in the ocular fundus. There are numerous studies on the epidemiology of AMD. Most studies differentiate between early and late forms of AMD, but without further differentiation of the “dry” late form. In addition, different studies may employ different classifications of AMD, which inevitably leads to deviations in epidemiological data on AMD. New classification systems take into account microstructural changes that can be detected by high resolution in vivo imaging of the retina. A new consensus classification of AMD-associated atrophy will allow future studies to be conducted according to uniform definitions.

Schlüsselwörter

altersabhängige Makuladegeneration - AMD - Epidemiologie - Klassifikation

Key words

age-related macular degeneration - AMD - epidemiology - classification

• Literatur

• 1 Mitchell P, Liew G, Gopinath B. et al. Age-related macular degeneration. Lancet 2018; 392: 1147-1159 doi:10.1016/S0140-6736(18)31550-2
• 2 Ferris 3rd FL, Wilkinson CP, Bird A. et al. Clinical classification of age-related macular degeneration. Ophthalmology 2013; 120: 844-851 doi:10.1016/j.ophtha.2012.10.036
• 3 de Oliveira Dias JR, Zhang Q, Garcia JMB. et al. Natural history of subclinical neovascularization in nonexudative age-related macular degeneration using swept-source OCT angiography. Ophthalmology 2018; 125: 255-266
• 4 Wong WL, Su X, Li X. et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis. Lancet Glob Health 2014; 2: e106-e116 doi:10.1016/S2214-109X(13)70145-1
• 5 Colijn JM, Buitendijk GHS, Prokofyeva E. et al. Prevalence of age-related macular degeneration in Europe: the past and the future. Ophthalmology 2017; 124: 1753-1763
• 6 Li JQ, Welchowski T, Schmid M. et al. Retinal Diseases in Europe. Prevalence, incidence and healthcare needs (August 2017). Im Internet: https://www.euretina.org/downloads/EURETINA_Retinal_Diseases.pdf Stand 01.04.2019
• 7 Fritsche LG, Fariss RN, Stambolian D. et al. Age-related macular degeneration: genetics and biology coming together. Annu Rev Genomics Hum Genet 2014; 15: 151-171
• 8 Fritsche LG, Igl W, Bailey JN. et al. A large genome-wide association study of age-related macular degeneration highlights contributions of rare and common variants. Nat Genet 2016; 48: 134-143
• 9 Casparis H, Lindsley K, Kuo IC. et al. Surgery for cataracts in people with age-related macular degeneration. Cochrane Database Syst Rev 2017; (02) CD006757
• 10 Cheung CM, Wong TY. Is age-related macular degeneration a manifestation of systemic disease? New prospects for early intervention and treatment. J Intern Med 2014; 276: 140-153
• 11 Pennington KL, DeAngelis MM. Epidemiology of age-related macular degeneration (AMD): associations with cardiovascular disease phenotypes and lipid factors. Eye Vis (Lond) 2016; 3: 34
• 12 Kabasawa S, Mori K, Horie-Inoue K. et al. Associations of cigarette smoking but not serum fatty acids with age-related macular degeneration in a Japanese population. Ophthalmology 2011; 118: 1082-1088
• 13 Trauzettel-Klosinski S. [Current possibilities of visual rehabilitation]. Ophthalmologe 2018; 115: 895-910
• 14 Jonas JB, Cheung CMG, Panda-Jonas S. Updates on the epidemiology of age-related macular degeneration. Asia Pac J Ophthalmol (Phila) 2017; 6: 493-497 doi:10.22608/APO.2017251
• 15 Mauschitz MM, Li JQ, Larsen PP. et al. [Epidemiology of severe visual impairment and blindness of old people in Germany]. Ophthalmologe 2019; 116: 201-212 doi:10.1007/s00347-019-0853-y
• 16 Brody BL, Gamst AC, Williams RA. et al. Depression, visual acuity, comorbidity, and disability associated with age-related macular degeneration. Ophthalmology 2001; 108: 1893-1901
• 17 Wood JM, Lacherez P, Black AA. et al. Risk of falls, injurious falls, and other injuries resulting from visual impairment among older adults with age-related macular degeneration. Invest Ophthalmol Vis Sci 2011; 52: 5088-5092
• 18 Woo SJ, Park KH, Ahn J. et al. Cognitive impairment in age-related macular degeneration and geographic atrophy. Ophthalmology 2012; 119: 2094-2101
• 19 Tsai DC, Chen SJ, Huang CC. et al. Age-related macular degeneration and risk of degenerative dementia among the elderly in Taiwan: a population-based cohort study. Ophthalmology 2015; 122: 2327-2335.e2
• 20 Keenan TD, Goldacre R, Goldacre MJ. Associations between age-related macular degeneration, Alzheimer disease, and dementia: record linkage study of hospital admissions. JAMA Ophthalmol 2014; 132: 63-68
• 21 McGuinness MB, Karahalios A, Finger RP. et al. Age-related macular degeneration and mortality: a systematic review and meta-analysis. Ophthalmic Epidemiol 2017; 24: 141-152
• 22 Age-Related Eye Disease Study Research Group. The Age-Related Eye Disease Study system for classifying age-related macular degeneration from stereoscopic color fundus photographs: the Age-Related Eye Disease Study Report Number 6. Am J Ophthalmol 2001; 132: 668-681
• 23 Klein R, Meuer SM, Myers CE. et al. Harmonizing the classification of age-related macular degeneration in the three-continent AMD consortium. Ophthalmic Epidemiol 2014; 21: 14-23 doi:10.3109/09286586.2013.867512
• 24 Spaide RF. Improving the age-related macular degeneration construct: a new classification system. Retina 2018; 38: 891-899 doi:10.1097/IAE.0000000000001732
• 25 Bindewald A, Schmitz-Valckenberg S, Jorzik JJ. et al. Classification of abnormal fundus autofluorescence patterns in the junctional zone of geographic atrophy in patients with age related macular degeneration. Br J Ophthalmol 2005; 89: 874-878
• 26 Fritsche LG, Fleckenstein M, Fiebig BS. et al. A subgroup of age-related macular degeneration is associated with mono-allelic sequence variants in the ABCA4 gene. Invest Ophthalmol Vis Sci 2012; 53: 2112-2118 doi:10.1167/iovs.11-8785
• 27 Westeneng-van Haaften SC, Boon CJ. et al. Clinical and genetic characteristics of late-onset Stargardtʼs disease. Ophthalmology 2012; 119: 1199-1210 doi:10.1016/j.ophtha.2012.01.005
• 28 Fleckenstein M, Schmitz-Valckenberg S, Lindner M. et al. The “diffuse-trickling” fundus autofluorescence phenotype in geographic atrophy. Invest Ophthalmol Vis Sci 2014; 55: 2911-2920 doi:10.1167/iovs.13-13409
• 29 Fleckenstein M, Grassmann F, Lindner M. et al. Distinct genetic risk profile of the rapidly progressing diffuse-trickling subtype of geographic atrophy in age-related macular degeneration (AMD). Invest Ophthalmol Vis Sci 2016; 57: 2463-2471 doi:10.1167/iovs.15-18593
• 30 Smailhodzic D, Fleckenstein M, Theelen T. et al. Central areolar choroidal dystrophy (CACD) and age-related macular degeneration (AMD): differentiating characteristics in multimodal imaging. Invest Ophthalmol Vis Sci 2011; 52: 8908-8918 doi:10.1167/iovs.11-7926
• 31 Biarnés M, Forero CG, Arias L. et al. Reappraisal of geographic atrophy patterns seen on fundus autofluorescence using a latent class analysis approach. Invest Ophthalmol Vis Sci 2014; 55: 8302-8308 doi:10.1167/iovs.13-13542
• 32 Holz FG, Bindewald-Wittich A, Fleckenstein M. et al. Progression of geographic atrophy and impact of fundus autofluorescence patterns in age-related macular degeneration. Am J Ophthalmol 2007; 143: 463-472
• 33 Schmitz-Valckenberg S, Sahel JA, Danis R. et al. Natural history of geographic atrophy progression secondary to age-related macular degeneration (Geographic Atrophy Progression Study). Ophthalmology 2016; 123: 361-368 doi:10.1016/j.ophtha.2015.09.036
• 34 Shen LL, Liu F, Nardini HG. et al. Reclassification of fundus autofluorescence patterns surrounding geographic atrophy based on progression rate: a systematic review and meta-analysis. Retina 2019;
• 35 Schmitz-Valckenberg S, Bindewald-Wittich A, Dolar-Szczasny J. et al. Correlation between the area of increased autofluorescence surrounding geographic atrophy and disease progression in patients with AMD. Invest Ophthalmol Vis Sci 2006; 47: 2648-2654
• 36 Fleckenstein M, Mitchell P, Freund KB. et al. The progression of geographic atrophy secondary to age-related macular degeneration. Ophthalmology 2018; 125: 369-390 doi:10.1016/j.ophtha.2017.08.038
• 37 Sadda SR, Guymer R, Holz FG. et al. Consensus definition for atrophy associated with age-related macular degeneration on OCT: Classification of Atrophy Report 3. Ophthalmology 2018; 125: 537-548 doi:10.1016/j.ophtha.2017.09.028