Fundus Photograph Reading Center
AREDS Summary Maculopathy Grading Form
| Reading List ___ - ___ - ___ - ___ | ||||
| Clinic ___ ___ | Patient ID ___ ___ ___ | FOR KEY ENTRY USE | ||
| Name Code ___ ___ ___ ___ ___ ___ | Photo Date ___ ___ /___ ___ /___ ___ | Pass |
Date |
Cert. No. |
| Grader ___ ___ Initials ___ ___ ___ | Date Graded ___ ___ /___ ___ /___ ___ | 1 |
__________ |
________ |
| 2 | __________ |
________ |
||
| EYE R(0) L(1) | Present | Missing |
|||||||||
| Field 1M | 0 |
2 |
|||||||||
| Field 2 | 0 |
2 |
|||||||||
| Field 3M | 0 |
2 |
|||||||||
| MACULOPATHY | None 0 |
Quest or Def 2 |
CG 8 |
||||||||
| a. Detachments | 0/No 1/Quest 2/Yes, quantitate definite presence in DA 8/CG | ||||||||||
| AREA within F2 ____ DA | |||||||||||
Field 2 |
C/Sub+Inners |
||||||||||
| None | Quest |
Yes |
CG |
None | Quest |
Yes |
CG |
||||
| Drusenoid PED | 0 |
1 |
2 |
8 |
0 |
1 |
2 |
8 |
|||
| **Non-drusenoid PED | 0 |
1 |
2 |
8 |
0 |
1 |
2 |
8 |
|||
| Type (circle one) | 1. Dome 2. Shallow 3. Irregular | ||||||||||
| **SSR/Hemorrhagic RD | 0 |
1 |
2 |
8 |
0 | 1 |
2 |
8 |
|||
| b. Hard Exudate | 0 |
1 |
2 |
8 |
0 |
1 |
2 |
8 |
|||
| **c. Subretinal/SubRPE Hemorrhage | 0 |
1 |
2 |
8 |
0 |
1 |
2 |
8 |
|||
| **d. Subretinal Fibrosis | 0 |
1 |
2 |
8 |
0 |
1 |
2 |
8 |
|||
| **e. PC/AMD | 0 |
1 |
2 |
8 |
0 |
1 |
2 |
8 |
|||
| f. Geographic Atrophy **Center Point Area C/Sub Area Center+Inners Area W/I Grid |
None 0 0 0 0 |
Quest 1 1 1 1 |
<I2 2 2 2 2 |
<O2 - 3 3 3 |
<½DA - 4 4 4 |
<1DA - - 5 5 |
<2DA - - 6 6 |
³ 2DA- - 7 7 |
CG 8 8 8 8 |
||
| g. RPE Depigmentation Area C/Sub Area C/Sub+Inners Area W/I Grid |
None 0 0 0 |
Quest 1 1 1 |
<I2 2 2 2 |
<O2 3 3 3 |
<½DA 4 4 4 |
<1DA - 5 5 |
<2DA - 6 6 |
³ 2DA- 7 7 |
CG 8 8 8 |
||
| h. Increased Pigment Area C/Sub Area C/Sub+Inners Area W/I Grid |
None 0 0 0 |
Quest 1 1 1 |
<C0 2 2 2 |
<C1 3 3 3 |
<C2 4 4 4 |
<O2 5 5 5 |
³ O26 6 6 |
Other 7 7 7 |
CG 8 8 8 |
**End Stage - If at least code 2 in any section, or for GA code 1 at center point and
³ code 2 in center subfield.| CONFOUNDING OCULAR
LESION(S) Quest or definitely present |
None 0 |
Yes 2 |
CG 8 |
|||||||
| None | Quest |
Yes |
CG |
Lesion# |
Abbreviation |
|||||
Lesion 1 |
0 |
1 |
2 |
8 |
__ __ |
__ __ __ __ __ __ __ |
||||
Lesion 2 |
0 |
1 |
2 |
8 |
__ __ |
__ __ __ __ __ __ __ |
||||
Lesion 3 |
0 |
1 |
2 |
8 |
__ __ |
__ __ __ __ __ __ __ |
||||
| OTHER OCULAR LESION(S) Quest or definitely present |
None 0 |
Yes 2 |
CG 8 |
|||||||
| None | Quest |
Yes |
CG |
Lesion# |
Abbreviation |
|||||
Lesion 1 |
0 |
1 |
2 |
8 |
__ __ |
__ __ __ __ __ __ __ |
||||
Lesion 2 |
0 |
1 |
2 |
8 |
__ __ |
__ __ __ __ __ __ __ |
||||
Lesion 3 |
0 |
1 |
2 |
8 |
__ __ |
__ __ __ __ __ __ __ |
||||
| DRUSEN W/I GRID Quest or definitely present |
None 0 |
Quest or Def 2 |
ES 7 |
CG 8 |
| MAXIMUM DRUSEN SIZE |
|
SOFT DRUSEN | ||||
| W/I Grid | W/I Grid | |||||
| None Quest <C0 (63) <C1 (125) <C2 (250) ³ C2Can't grade |
0 1 2 3 4 5 8 |
None Soft distinct Soft indistinct Can't grade |
0 1 2 8 |
|||
| AREA W/I GRID | None/Quest/<C0 |
<C1 |
<C2 |
<I2 |
<O2 |
<½DA |
<1DA |
³ 1DA |
CG |
ES |
|
| C/Sub Only Center+Inners W/I Grid |
0 0 0 |
1 1 1 |
2 2 2 |
3 3 3 |
4 4 4 |
5 5 5 |
- 6 6 |
- 7 7 |
8 8 8 |
9 9 9 |
|
| DRUSEN AREA Outside Grid+F1+F3 |
None/Quest/<O2 0 |
- |
- |
- |
- |
³ O25 |
- |
- |
CG 8 |
|
|
RETICULAR DRUSEN |
None 0 |
Quest 1 |
Outside Grid 2 |
W/I Grid ± Outside Grid 3 |
CG 8 |
|
| CALCIFIED DRUSEN W/I or Outside Grid |
None 0 |
Quest 1 |
Yes 2 |
- |
CG 8 |
| COMMENTS______________________________________________________________________________________ _________________________________________________________________________________________________ |
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29Feb2000