IRIS PIGMENTATION AND EXTENT OF DISEASE IN PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION

Purpose. To determine whether the extent of disease in age-related mac ular degeneration (AMD) varies with iris pigmentation. Methods. The au thors assessed visual function and macular appearance in the fellow ey e or both eyes of 132 white patients with unilateral neovascular AMD. All patients had a visual acuity of 20/60 or better in the fellow eye. Eighty-nine of the patients were coded as having light irides (blue, green, or hazel) and 43 were coded as having dark irides (brown); the two groups of patients had; comparable mean ages. Results. By the Mann -Whitney test for differences in mean rank, fellow eyes with light iri des showed a marginally worse visual acuity (P = .156) but significant ly more visual field impairment by letter recognition perimetry (P = . 011) and the macular thr eshold test of the Humphrey Field Analyzer (P = .043), and more retinal pigment epithelial atrophy (P = .017) and f ocal areas of hyperpigmentation (P = .002) than fellow eyes with dark irides. For eyes with a choroidal neovascular membrane (CNVM), those w ith light irides had significantly lower visual acuities (P = .006) an d larger scars (P = .006) than eyes with dark irides. In addition, ext ent of disease in the eye with a CNVM was positively correlated with e xtent of disease in the fellow eye for most comparisons. Conclusions. These observations suggest that light iris pigmentation is associated with more extensive retinal disease in patients with unilateral neovas cular AMD. Furthermore, in such patients, those with worse disease in the eye with a CNVM may tend to have more extensive atrophic disease i n the fellow eye.