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Updated: May 2, 2026
Author Spotlight: Ex Vivo OCT-Based Multimodal Imaging of Human Donor Eyes for Research into Age-Related Macular Degeneration
Published on: May 26, 2023
A risk score for the prediction of advanced age-related macular degeneration: development and validation in 2
Chung-Jung Chiu1, Paul Mitchell2, Ronald Klein3
1Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts; Department of Ophthalmology, School of Medicine, Tufts University, Boston, Massachusetts.
Purpose:
To develop a clinical eye-specific prediction model for advanced age-related macular degeneration (AMD).
Design:
The Age-Related Eye Disease Study (AREDS) cohort followed up for 8 years served as the training dataset, and the Blue Mountains Eye Study (BMES) cohort followed up for 10 years served as the validation dataset.
Participants:
A total of 4507 AREDS participants (contributing 1185 affected vs. 6992 unaffected eyes) and 2169 BMES participants (contributing 69 affected vs. 3694 unaffected eyes).
Methods:
Using Bayes' theorem in a logistic model, we used 8 baseline predictors-age, sex, education level, race, smoking status, and presence of pigment abnormality, soft drusen, and maximum drusen size-to devise and validate a macular risk scoring system (MRSS). We assessed the performance of the MRSS by calculating sensitivity, specificity, and the area under the receiver operating characteristic curve (i.e., c-index).
Main Outcome Measures:
Advanced AMD.
Results:
The internally validated c-indexAREDS (0.88; 95% confidence interval, 0.87-0.89) and the externally validated c-indexBMES (0.91; 95% confidence interval, 0.88-0.95) suggested excellent performance of the MRSS. The sensitivity and specificity at the optimal macular risk score cutoff point of 0 were 87.6% and 73.6%, respectively. An application for the iPhone and iPad also was developed as a practical tool for the MRSS.
Conclusions:
The MRSS was developed and validated to provide satisfactory accuracy and generalizability. It may be used to screen patients at risk of developing advanced AMD.
