Abstract
Purpose: To review novel findings in research with ultra-widefield imaging for analysis of peripheral manifestations in macular degeneration (AMD). We introduce the evolving widefield imaging modalities while summarizing the analytical techniques used in data collection of peripheral retinal findings thus far. Our review provides a summary of advancements to date and a commentary on future direction for AMD research. Methods: This is a literature review of all significant publications focused on the relationship between AMD and the retinal periphery conducted within the last two decades. Results and Conclusion: Promising research has been undertaken to elucidate peripheral retinal manifestations in macular degeneration using novel methodology. Advancements in ultra-widefield imaging and fundus autofluorescence have allowed us to elucidate peripheral retinal pigmentary changes, drusen deposition, and much more. Novel grid overlay techniques have been introduced to aid in analyzing these changes for pattern recognition and grouping of findings. This review discusses these findings in detail, providing evidence for the pan-retinal manifestations of AMD. Inter-study discordance in analytical approach highlights a need for more systematic future study.
Highlights
Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the elderly population of developed countries worldwide
With the growing application of ultra-widefield (UWF) fundus imaging for detection of peripheral retinal manifestations, we have recently developed a novel UWF image-based grid grading system for methodical study of peripheral retinal findings [2]
Before the development of confocal scanning laser ophthalmoscope (cSLO) systems, standard fundus camera photography acted as our primary mode of fundus autofluorescence (FAF) image acquisition, limiting our view of the peripheral retina and ability to study the pathogenesis of diseases such as AMD
Summary
Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the elderly population of developed countries worldwide. AMD differentiates this disease from the dry, usually more slowly progressing, form [1]. While studies show that peripheral pigmentary, drusenoid, and atrophic retinal changes are common in AMD patients, the impact of these findings on the disease is not well understood. Recent developments in imaging technology have allowed us to analyze peripheral retinal findings more systematically. With the growing application of ultra-widefield (UWF) fundus imaging for detection of peripheral retinal manifestations, we have recently developed a novel UWF image-based grid grading system for methodical study of peripheral retinal findings [2]. We present recent studies and technological advancements made in identifying the peripheral manifestations of AMD in hope of developing a more cohesive understanding of the disease. We aim to give a background on widefield retinal imaging and image analysis while sequentially describing the recorded findings of AMD studies
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