The nine-step minnesota grading system for eyebank eyes with age related macular degeneration: A systematic approach to study disease stages

Timothy W. Olsen, Albert Liao, Hershonna S. Robinson, Neal Palejwala, Nicholas Sprehe

Research output: Contribution to journalArticle

2 Scopus citations


PURPOSE. To refine the Minnesota Grading System (MGS) using definitions from the Age-Related Eye Disease Studies (AREDS) into a nine-step grading scale (MGS-9).METHODS. A nine-step grading scale descriptive analysis using three key phenotypic features (total drusen area, increased, and decreased pigmentation) of human eyebank eyes that were graded according to definitions from the AREDS criteria in order to harmonize studies of disease progression for research involving human tissue. From 2005 through February 2017, we have analyzed 1159 human eyes, procured from two eyebanks. Each macula was imaged using high-resolution, stereoscopic color fundus photography with both direct- and transillumination. Fundus images were digitally overlaid with a grading template and triangulated for foveal centration.RESULTS. We documented and stratified risk for each globe by applying the AREDS nine-step grading scale to the key clinical features from the MGS-9. We found a good distribution within the MGS categories (1-9) with few level eight globes. Eyes were processed within 12.1 ± 6.3, hours from the time of death through imaging, dissection, and freezing or fixation. Applying the MGS-9 to 331 pairs (662 eyes were simultaneously graded), 84% were within one-grading step and 93% within two steps of the fellow eye. We also document reticularpseudodrusen,basal laminar drusen, and pattern dystrophy.CONCLUSIONS. The MGS nine-step grading scale enables researchers using human tissue to refine the risk assessment of donor tissue. This analysis will harmonize results among researchers when grading human tissue using MGS criteria. Most importantly, the MGS-9 links directly to the known risk for progression from the AREDS.

Original languageEnglish (US)
Pages (from-to)5497-5506
Number of pages10
JournalInvestigative Ophthalmology and Visual Science
Issue number12
Publication statusPublished - Oct 1 2017
Externally publishedYes



  • Eyebank
  • Grading system
  • Human tissue

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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