Wenzhou Dry Age-related Macular Degeneration (AMD) Progression Study

Study Overview
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Brief Summary
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To evaluate the correlation between macular pigment optical density (MPOD) levels and risk of progression in patients with age-related macular degeneration

Detailed Description
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Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly.[1] The disease is categorized into early, intermediate, or advanced stages based on the severity of symptoms. The advanced stage, including GA and CNV, involves central region of the retina, which leads to a gradual or rapid loss of photoreceptors and central vision. The macular pigment (MP) consists of xanthophyll, which is formed from the yellow carotenoid lutein, zeaxanthin, and meso-zeaxanthin.These pigments play an important role in protecting the retina against oxidative stress through different mechanisms[6]. Many studies have shown a various association of AMD and MP.Blue Mountain Eye Study revealed low dietary intake of lutein and zeaxanthin is associated with a higher risk of AMD. However, dry and wet subtypes of AMD may have different etiologies and risk factors. Little is known whether longitudinal study of macular pigment optical density (MPOD) is related to AMD progression. A comprehensive ophthalmologic examination including fundus photography,OCT and MPOD was performed at baseline, and semiannually thereafter for 3 years. Fundus reflectance (VISUCAM 500, reflectance of a single 460 nm wavelength) was used to measure the MPOD levels. Associated risk factors including body-mass index (BMI), smoking, diet, and cardiovascular diseases were documented. Drusen characteristics (size, type, area), pigmentary abnormalities (increased pigment, depigmentation, geographic atrophy), and presence of abnormalities characteristic of neovascular AMD were graded. For estimations of AMD progression , a 9-step severity scale that combines a 6-step drusen area scale with a 5-step pigmentary abnormality scale is used. In this study, we are going to investigate a 3-year study of incidence and progression for AMD and associated risk factors, in a population-based cohort of Chinese aged 45 years and older living in the city of Wenzhou.

Official Title
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Progression of Dry Age-related Macular Degeneration (AMD): Association With Macular Pigment Optical Density (MPOD)

Conditions
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Macular Pigment Optical Density

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: subject is diagnosed with either CNV, dry AMD 45 years of age or older provides signed and dated informed consent Exclusion Criteria: Ocular condition in the study eye which may impact vision and confound study outcomes Presence of macular edema like retinal vascular diseases or diabetic retinopathy active inflammation ofr infection in the study eye high myopia（ ≥6D ）

Ages Eligible for Study
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Minimum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Progressors<br>Progressors are those individuals with early or intermediate AMD at baseline who progress to advanced AMD during follow-up, and individuals with advanced AMD in one eye at baseline who progress to advanced AMD in both eyes. | |
| Nonprogressor<br>Nonprogressors are those individuals with early or intermediate AMD at baseline who do not progressed to advanced AMD during follow-up, and individuals with advanced AMD in one eye at baseline who do not progress to advanced AMD in fellow eye. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Association between changes of macular pigment optical density (MPOD) level and incidence rates of advanced AMD | Incident advanced AMD was evaluated based on the AMD grade at the end of the clinical trial with follow-up time of 3 years. Progressors were those individuals with early or intermediate AMD at baseline who progressed to advanced AMD during follow-up, and individuals with advanced AMD in one eye at baseline who progressed to advanced AMD in both eyes | from baseline to month 36 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Association between age and incident Advanced AMD | controlling for age (70 years or older versus younger than 70) | baseline | 
| Association between gender and incident Advanced AMD |  | baseline | 
| Association between Baseline AMD grade and incident Advanced AMD | Baseline AMD grade was deﬁned as AREDS category 1 in both eyes (essentially free of age-related macular abnormalities), category 2 in the worst eye (mild changes including multiple small drusen, nonextensive intermediate drusen, and/or pigment abnormalities), category 3 in the worst eye (at least one large drusen of at least 125µm diameter, extensive intermediate drusen, and/or noncentral geographic atrophy), category 4 in one eye (advanced AMD, either neovascular or central geographic atrophy, or visual loss due to AMD regardless of phenotype), or category 4 in both eyes. | baseline | 
| Association between cigarette smoking and incident Advanced AMD | cigarette smoking information was acquired by questionaires(never, past, or current) . | baseline | 
| Association between body mass index (BMI) and incident Advanced AMD | BMI was calculated as the weight in kilograms divided by the square of the height in meters ( 25, 25-29.9, and 30 ) | baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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macular pigment optical density (MPOD), Age-related Macular Degeneration (AMD), drusen, Chroidal neovascularization (CNV), lutein, zeaxanthin