A new, online risk assessment model will help eye care providers more easily identify whether patients with AMD will experience disease progression and/or visual compromise.

Michael Klein, M.D., and associates at the Casey Eye Institute at the Oregon Health and Science University in Portland used phenotypic, demographic, environmental and genetic risk factors—in particular visual data from 2,846 patients enrolled in the Age-Related Eye Disease Study (AREDS)—to design this risk assessment model.¹ 

The researchers evaluated longitudinal data from AREDS participants who had all levels of AMD, ranging from none to unilateral advanced AMD.

With this information in hand, they performed “a Cox proportional hazards analysis with demographic, environmental, phenotypic and genetic covariates.”1The final model takes into account these independent variables: age; smoking history; family history of AMD (first-degree member); phenotype based on a modified AREDS simple scale score; and genetic variants CFH Y402H and ARMS2 A69S.

After testing the calculator’s validity, the authors wrote, “the model did well on performance measures, with very good discrimination and excellent calibration and overall performance. Successful external validation was performed, and a risk assessment tool was designed for use with or without the genetic component.”

They conclude, “We believe our current model is of substantial value in assessing AMD risk, and we expect that future advances will further improve its accuracy.”

Their findings appear in an article published in the December 2011 Archives of Ophthalmology.

In a related editorial, Ronald Klein, M.D., M.P.H., professor in the department of ophthalmology and visual sciences at the University of Wisconsin School of Medicine and Public Health, and associates commented on the clinical significance of Dr. Michael Klein’s predictive model.2 “Knowing the severity of the lesions of AMD that are already present, coupled with knowledge of important lifestyle factors, gives most of the important information about risk of progression.”

The AMD Risk Assessment Calculator is available at: http://caseyamdcalc.ohsu.edu.

1. Klein ML, Francis PJ, Ferris FL 3rd, et al. Risk assessment model for development of advanced age-related macular degeneration. Arch Ophthalmol. 2011 Dec;129(12):1543-50.
2. Klein R, Klein BE, Myers CE. Risk assessment models for late age-related macular degeneration. Arch Ophthalmol. 2011 Dec;129(12):1605-6.