To update the Age-Related Eye Disease Study (AREDS) simplified severity scale for risk of late age-related macular degeneration (AMD), including incorporation of reticular pseudodrusen (RPD), and to perform external validation on the Age-Related Eye Disease Study 2 (AREDS2). Post hoc analysis of 2 clinical trial cohorts: AREDS and AREDS2. Participants with no late AMD in either eye at baseline in AREDS (n = 2719) and AREDS2 (n = 1472). Five-year rates of progression to late AMD were calculated according to levels 0 to 4 on the simplified severity scale after 2 updates: (1) noncentral geographic atrophy (GA) considered part of the outcome, rather than a risk feature, and (2) scale separation according to RPD status (determined by validated deep learning grading of color fundus photographs). Five-year rate of progression to late AMD (defined as neovascular AMD or any GA). In the AREDS, after the first scale update, the 5-year rates of progression to late AMD for levels 0 to 4 were 0.3%, 4.5%, 12.9%, 32.2%, and 55.6%, respectively. As the final simplified severity scale, the 5-year progression rates for levels 0 to 4 were 0.3%, 4.3%, 11.6%, 26.7%, and 50.0%, respectively, for participants without RPD at baseline and 2.8%, 8.0%, 29.0%, 58.7%, and 72.2%, respectively, for participants with RPD at baseline. In external validation on the AREDS2, for levels 2 to 4, the progression rates were similar: 15.0%, 27.7%, and 45.7% (RPD absent) and 26.2%, 46.0%, and 73.0% (RPD present), respectively. The AREDS AMD simplified severity scale has been modernized with 2 important updates. The new scale for individuals without RPD has 5-year progression rates of approximately 0.5%, 4%, 12%, 25%, and 50%, such that the rates on the original scale remain accurate. The new scale for individuals with RPD has 5-year progression rates of approximately 3%, 8%, 30%, 60%, and 70%, that is, approximately double for most levels. This scale fits updated definitions of late AMD, has increased prognostic accuracy, seems generalizable to similar populations, but remains simple for broad risk categorization. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

中文翻译：

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包含网状假玻璃膜疣的年龄相关性黄斑变性更新简化严重程度量表：年龄相关性眼病研究报告第 42 号


更新年龄相关性眼病研究 （AREDS） 晚期年龄相关性黄斑变性 （AMD） 风险的简化严重程度量表，包括纳入网状假性玻璃膜疣 （RPD），并对年龄相关性眼病研究 2 （AREDS2） 进行外部验证。2 个临床试验队列的事后分析：AREDS 和 AREDS2。在 AREDS （n = 2719） 和 AREDS2 （n = 1472） 的基线时双眼没有晚期 AMD 的参与者。在 2 次更新后，根据简化严重程度量表的 0 至 4 级计算晚期 AMD 的五年进展率：（1） 非中央地理萎缩 （GA） 被视为结果的一部分，而不是风险特征，以及 （2） 根据 RPD 状态进行量表分离（通过经过验证的深度学习分级确定彩色眼底照片）。五年进展为晚期 AMD（定义为新生血管性 AMD 或任何 GA）的速度。在 AREDS 中，在第一次量表更新后，0 至 4 级进展为晚期 AMD 的 5 年率分别为 0.3% 、 4.5% 、 12.9% 、 32.2% 和 55.6%。作为最终的简化严重性量表，基线时无 RPD 参与者的 0 至 4 级 5 年进展率分别为 0.3%、4.3%、11.6%、26.7% 和 50.0%，基线时有 RPD 的参与者分别为 2.8%、8.0%、29.0%、58.7% 和 72.2%。在 AREDS2 的外部验证中，对于 2 至 4 级，进展率相似：分别为 15.0%、27.7% 和 45.7%（不存在 RPD）和 26.2%、46.0% 和 73.0%（存在 RPD）。AREDS AMD 简化严重性等级已通过 2 项重要更新进行了现代化改造。无 RPD 个体的新量表的 5 年进展率约为 0.5%、4%、12%、25% 和 50%，因此原始量表上的进展率保持准确。 RPD 个体的新量表的 5 年进展率约为 3%、8%、30%、60% 和 70%，即大多数水平大约翻了一番。该量表符合晚期 AMD 的最新定义，提高了预后准确性，似乎可以推广到类似的人群，但对于广泛的风险分类来说仍然很简单。专有或商业披露可在本文末尾的脚注和披露中找到。