The same grading scale that the Age-Related Eye Disease Study 2 (AREDS2) clinical trial used to establish short-term progression in age-related macular degeneration (AMD) can also be used to identify eyes at higher risk of late AMD and vision loss, according to research presented last week at ARVO 2019.

The scale in question graded baseline and annual fundus photographs to assign eyes a score between one and nine, depending on the level of drusen area and pigment changes. A ≥2 or ≥3-step increase from baseline to year two significantly increased the risk of late AMD and vision loss, even after adjusting for baseline AMD score and demographics, the Maryland-based research team found.

To establish the grading system’s application in AMD progression, the researchers looked at 5,919 eyes without late AMD. They found 12.7% had ≥2-step short-term progression and 3.9% had ≥3- step short-term progression from years two through five. They also noted significant neovascularization (12.7%), central geographic atrophy (7.3%), geographic atrophy (15.3%), ≥2-line visual acuity loss (27.2%) and ≥3-line visual acuity loss (15.6%).

Investigators suggest predicting late AMD risk could be improved by considering short-term progression using this trial’s scale.