Five-year incidence of age-related maculopathy: The Visual Impairment Project☆
Received 6 January 2003; accepted 19 August 2003.
Abstract
Purpose
To describe the 5-year incidence of age-related maculopathy (ARM) and the progression of the early stages of ARM lesions in Melbourne, Australia.
Design
Population-based cohort study.
Participants
A total of 3271 participants aged 40 years and older from Melbourne, Victoria, Australia.
Main outcome measures
The 5-year incidence and progression of ARM lesions.
Methods
Participants were recruited through a cluster random sampling from 9 urban clusters. Baseline examinations were conducted from 1992 through 1994, and the follow-up data were collected from 1997 through 1999. Presence of ARM lesions was graded from color stereo fundus photographs according to the International Classification and Grading System.
Results
The overall cumulative 5-year incidence of age-related macular degeneration (AMD) was 0.49% (95% confidence interval [CI], 0.2–0.8) and that of early ARM was 17.3% (95% CI, 8.7–26.0). The incidence of all ARM lesions increased with age (all P<0.001). The 5-year incidence of AMD was 0%, 0.69%, 1.7%, and 6.3% and that of early ARM was 13%, 22.7%, 29.8%, and 20% for participants aged 60 years and younger, aged 60 to 69 years, aged 70 to 79 years, and aged 80 years and older at baseline, respectively. People with soft indistinct drusen with pigmentary abnormalities had a 9.5 times (95% CI, 1.9–45.6) higher risk of developing AMD compared with people with soft drusen or pigmentary abnormalities. After adjusting for age, people with unilateral early ARM at baseline were 3 times (95% CI, 0.98–8.0) as likely to have early ARM in their second eye when compared with people with no ARM in both eyes.
Conclusions
These data suggest that 1 in 3 persons aged 70 years or older will have ARM lesions over a 5-year period and that the disease will progress to a more severe form after the age of 80 years. The presence of soft indistinct drusen with pigmentary abnormalities significantly increased the risk for development of AMD.
1Peter MacCallum Cancer Centre, East Melbourne, Australia
2Centre for Eye Research Australia, The University of Melbourne, Melbourne, Australia
3Centre for Vision Research, Department of Ophthalmology, the University of Sydney, Westmead Hospital, Sydney, Australia
4Marshfield Clinic Research Foundation, Marshfield, Wisconsin, USA
Correspondence to Bickol Mukesh, PhD, Biostatistics and Bioinformatics Core, Marshfield Clinic Research Foundation, Marshfield, WI 54449.
The Visual Impairment Project was funded in part by grants from the National Health and Medical Research Council, the Victorian Health Promotion Foundation, the estate of the late Dorothy Edols, the Ansell Ophthalmology Foundation, the Jack Brockhoff Foundation, the Eye Ear Nose and Throat Research Institute, and the Ian Potter Foundation, Australia. Dr McCarty was the recipient of the Wagstaff Research Fellowship in Ophthalmology from the Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.
ABSTRACT