Table 1 NICE guidelines-based classification of age-related macular degeneration [1].
AMD classification in NICE guidance | Definition in NICE guidance | Frequently used terminology |
|---|---|---|
Normal eyes | No signs of age-related macular degeneration (AMD) Small ('hard') drusen (less than 63 μm) only | No AMD |
Early AMD | Low risk of progression: –medium drusen (63 μm or more and less than 125 μm) or pigmentary abnormalities | Early AMD or age-related maculopathy |
Medium risk of progression: –large drusen (125 μm or more) or –reticular drusen or –medium drusen with pigmentary abnormalities High risk of progression: –large drusen (125 μm or more) with pigmentary abnormalities or –reticular drusen with pigmentary abnormalities or –vitelliform lesion without a significant visual loss (best-corrected acuity better than 6/18) or –atrophy smaller than 175 μm and not involving the fovea |
| |
Late AMD (indeterminate) | Retinal pigment epithelial (RPE) degeneration and dysfunction (presence of degenerative AMD changes with subretinal or intraretinal fluid in the absence of detectable neovascularisation) Serous pigment epithelial detachment (PED) without neovascularisation | |
Late AMD (wet active) | Classic choroidal neovascularisation (CNV)—Type 2 Occult (fibrovascular PED and serous PED with neovascularisation—Type 1 Mixed (predominantly or minimally classic CNV with occult CNV) Retinal angiomatous proliferation (RAP)—Type 3 Polypoidal choroidal vasculopathy (PCV) | Neovascular AMD (nAMD) or wet AMD |
Late AMD (dry) | Geographic atrophy (in the absence of neovascular AMD) Significant visual loss (6/18 or worse) associated with: –dense or confluent drusen or –advanced pigmentary changes and/or atrophy or –vitelliform lesion | Advanced dry AMD/geographic atrophy |
Late AMD (wet inactive) | Fibrous scar Sub-foveal atrophy or fibrosis secondary to an RPE tear Atrophy (absence or thinning of RPE and/or retina) Cystic degeneration (persistent intraretinal fluid or tubulations unresponsive to treatment) NB: eyes may still develop or have a recurrence of late AMD (wet active) | Advanced wet AMD/disciform scar |
Do not refer to late AMD (wet inactive) as 'dry AMD' | ||
Intermediate AMD