The Wisconsin age-related maculopathy grading system

Ophthalmology. 1991 Jul;98(7):1128-34. doi: 10.1016/s0161-6420(91)32186-9.


A new system for grading age-related maculopathy is described and measures of reliability are reported. A number of characteristics of age-related maculopathy are graded in a semiquantitative fashion from stereoscopic 30 degrees color fundus photographs, using a grid to define subfields, standard circles printed on plastic to assess size and area, and a specially designed lightbox to allow better discrimination of subtle drusen. The degree of exact agreement achieved between two trained graders across a variety of lesions ranged from 67.1% for drusen size to 99.6% for geographic atrophy. Kappa scores ranged from 0.55 (for drusen confluence) to 0.95 for geographic atrophy. This system will be useful in epidemiologic studies and clinical trials.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aging / pathology
  • Fundus Oculi
  • Humans
  • Macular Degeneration / classification
  • Macular Degeneration / pathology*
  • Photography
  • Reproducibility of Results
  • Retinal Drusen / pathology
  • Wisconsin