Five-year incidence of age-related maculopathy lesions: the Blue Mountains Eye Study.

PURPOSE To describe the 5-year incidence and progression of early and late age-related maculopathy (ARM) lesions. DESIGN Population-based cohort study. PARTICIPANTS Three thousand six hundred fifty-four noninstitutionalized residents, aged 49 years or older, living in the Blue Mountains area west of Sydney, Australia, participated in the study during 1992 to 1994. The cohort was reexamined after 5 years (1997-1999). Excluding 543 participants who died since the baseline, 2335 (75%) survivors attended 5-year follow-up examinations. METHODS Retinal photographs from both examinations were graded using the Wisconsin ARM Grading System. Photographs of participants with any ARM lesions at either examination were regraded in detail using a modification of the side-by-side method developed for the Beaver Dam Eye Study. MAIN OUTCOME MEASURES Incidence and progression of ARM lesions were defined in a similar manner to that used in the Beaver Dam Eye Study. RESULTS Incidence rates for all ARM lesions increased significantly with age. For late ARM lesions (geographic atrophy and neovascular ARM), the overall 5-year incidence was 1.1%. The combined late ARM incidence was 0.0%, 0.6%, 2.4%, and 5.4% for participants aged 60 years and younger, 60 to 69 years, 70 to 79 years, and 80 years and older at baseline, respectively. After excluding participants with either early or late ARM in either eye at baseline, the overall 5-year incidence of early ARM was 8.7%, including 3.2%, 7.4%, 18.3%, and 14.8% for the corresponding age groups. The incidence of neovascular ARM in women was double that for men (P = 0.1). CONCLUSIONS This study has documented the incidence of ARM lesions in an older Australian population. The slightly higher incidence of hyperpigmentation found in our population compared with the Beaver Dam Eye Study may be due to sample variability, or this could reflect real differences between the two populations. Our lower incidence of soft drusen could have resulted from our non-inclusion of intermediate soft drusen in the soft distinct and indistinct drusen categories.

[1]  P. Mitchell,et al.  Smoking and age-related maculopathy. The Blue Mountains Eye Study. , 1996, Archives of ophthalmology.

[2]  A. Bird,et al.  Senile disciform macular degeneration in the second eye. , 1977, The British journal of ophthalmology.

[3]  J M Gibson,et al.  Seven year follow-up of age-related maculopathy in an elderly British population , 1997, Eye.

[4]  J. Slakter,et al.  Choroidal neovascularization in second eyes of patients with unilateral exudative age-related macular degeneration. , 1995, Ophthalmology.

[5]  R. Klein,et al.  Changes in visual acuity in a population. The Beaver Dam Eye Study. , 1996, Ophthalmology.

[6]  S. Chapman,et al.  “Smoking is a major cause of blindness” , 1999, The Medical journal of Australia.

[7]  I. Shami.  Smoking and age-related maculopathy , 1997 .

[8]  S. Fine,et al.  The second eye of patients with senile macular degeneration. , 1983, Archives of ophthalmology.

[9]  M. Kaiser-Kupfer,et al.  Second eye involvement in age-related macular degeneration: A four-year prospective study , 1990, Eye.

[10]  R. Klein,et al.  Ten-year incidence and progression of age-related maculopathy: The Beaver Dam eye study. , 2002, Ophthalmology.

[11]  M. Maguire.  More pieces for the age-related macular degeneration puzzle. , 1997, Ophthalmology.

[12]  R L Cooper,et al.  Blind registrations in Western Australia: a five-year study. , 1990, Australian and New Zealand journal of ophthalmology.

[13]  S. Fine,et al.  Prognosis of patients with bilateral macular drusen. , 1984, Ophthalmology.

[14]  P. Mitchell,et al.  Visual acuity and the causes of visual loss in Australia. The Blue Mountains Eye Study. , 1996, Ophthalmology.

[15]  J. J. Wang,et al.  Prevalence of age-related maculopathy in Australia. The Blue Mountains Eye Study. , 1995, Ophthalmology.

[16]  P T de Jong,et al.  An international classification and grading system for age-related maculopathy and age-related macular degeneration , 1995 .

[17]  R. Klein,et al.  The Beaver Dam Eye Study. Retinopathy in adults with newly discovered and previously diagnosed diabetes mellitus. , 1992, Ophthalmology.

[18]  A C Bird,et al.  Bilateral macular drusen in age-related macular degeneration. Prognosis and risk factors. , 1994, Ophthalmology.

[19]  J D Gass,et al.  Drusen and disciform macular detachment and degeneration. , 1973, Archives of ophthalmology.

[20]  M G Maguire,et al.  Five-year incidence and disappearance of drusen and retinal pigment epithelial abnormalities. Waterman study. , 1995, Archives of ophthalmology.

[21]  R. Klein,et al.  The Wisconsin age-related maculopathy grading system. , 1991, Ophthalmology.