TY - JOUR A1 - Soundara Pandi, Sudha A1 - Rajendran, Anand A1 - Radha Krishnan, Santhi A1 - Anto, Minu A1 - Gardiner, Tom A1 - Chakravarthy, Usha A1 - Veerappan, Muthukkaruppan T1 - Characterization of age-related macular degeneration in Indian donor eyes Y1 - 2021/3/1 JF - Indian Journal of Ophthalmology JO - Indian J Ophthalmol SP - 642 EP - 646 VL - 69 IS - 3 UR - https://journals.lww.com/ijo/pages/default.aspx/article.asp?issn=0301-4738;year=2021;volume=69;issue=3;spage=642;epage=646;aulast=Soundara DO - 10.4103/ijo.IJO_291_20 N2 - Purpose: The purpose of this study was to test the reliability of fundus stereomicroscopy in postmortem eyes to assign severity of age-related macular degeneration (AMD) using the Minnesota grading and confirmation by histology using Alabama and Sarks grading scales and to assess the incidence of AMD pathology in donor eyes from a South Indian population. Methods: Eyes (199) from 153 donors (55–95 years) after obtaining fundus images were processed for histology. Fundus images were graded according to the Minnesota grading system based on drusen size, area of depigmentation, and atrophy. At least one eye from each donor displaying the AMD phenotypes were subjected to histological examination. The fundus grading was correlated with histology and the stages of AMD assigned for early AMD by the Alabama AMD grading system and for both early and advanced AMD by the Sarks classification. Results: Stereoscopic examination of the fundus found that 10 of the 153 donors had features of early AMD and 3 advanced AMD. Following histological examination, one of the early AMD eyes was reclassified as advanced AMD. Early AMD features that were observed on histology included soft drusen (>63 μm), basal laminar deposits, photoreceptor outer segment degeneration, disorganization of retinal pigment epithelium (RPE), Bruch's membrane thickening. Advanced AMD features observed in histology are extensive atrophy of RPE, choroidal neovascularization and disciform scar formation. Conclusion: Identification of either early or advanced AMD using stereomicroscopic assessment (SMA) showed high sensitivity and specificity. However, misclassification between AMD stages can occur when only SMA is used. ER -