AN INTERNATIONAL CLASSIFICATION AND GRADING SYSTEM FOR AGE-RELATED MACULOPATHY AND AGE-RELATED MACULAR DEGENERATION

A common detection and classification system is needed for epidemiolog ic studies of age-related maculopathy (ARM). Such a grading scheme for ARM is described in this paper. ARM is defined as a degenerative diso rder in persons greater-than-or-equal-to 50 years of age characterized on grading of color fundus transparencies by the presence of the foll owing abnormalities in the macular area: soft drusen greater-than-or-e qual-to 63mum, hyperpigmentation and/or hypopigmentation of the retina l pigment epithelium (RPE), RPE and associated neurosensory detachment , (peri)retinal hemorrhages, geographic atrophy of the RPE, or (peri)r etinal fibrous scarring in the absence of other retinal (vascular) dis orders. Visual acuity is not used to define the presence of ARM. Early ARM is defined as the presence of drusen and RPE pigmentary abnormali ties described above; late ARM is similar to age-related macular degen eration (AMD) and includes dry AMD (geographic atrophy of the RPE in t he absence of neovascular AMD) or neovascular AMD (RPE detachment, hem orrhages, and/or scars as described above). Methods to take and grade fundus transparencies are described.