Prevalence Of Age-related Maculopathy Research Articles

Prevalence of Age-related Maculopathy: The Beaver Dam Eye Study

The relationships of retinal drusen, retinal pigmentary abnormalities, and macular degeneration to age and sex were studied in 4926 people between the ages of 43 and 86 years who participated in the Beaver Dam Eye Study. The presence and severity of various characteristics of drusen and other lesions typical of age-related maculopathy were determined by grading stereoscopic color fundus photographs using the Wisconsin Age-Related Maculopathy Grading System. One or more drusen were present in the macular area of at least 1 eye in 95.5% of the population. People 75 years of age or older had significantly higher frequencies (P < 0.01) of the following characteristics than people 43 to 54 years of age: larger sized drusen (>125 /μm, 24.0% versus 1.9%), soft indistinct drusen (23.0% versus 2.1%), retinal pigment abnormalities (26.6% versus 7.3%), exudative macular degeneration (5.2% versus 0.1%), and geographic atrophy (2.0% versus 0%). These data indicate signs of age-related maculopathy are common in people 75 years of age or older and may pose a substantial public health problem.

Gene therapy for the long term treatment of wet AMD

Age-related macular degeneration (AMD) is the most common cause of visual impairment in elderly populations of the developed world, 1 Klein R Klein BE Linton KL Prevalence of age-related maculopathy. The Beaver Dam Eye Study. Ophthalmology. 1992; 99: 933-943 Summary Full Text PDF PubMed Scopus (1614) Google Scholar and neovascular AMD (wet AMD) accounts for 90% of severe vision loss in patients with AMD. Wet AMD is associated with the upregulation of vascular endothelial growth factor (VEGF), which promotes angiogenesis and vascular permeability. 2 Kwak N Okamoto N Wood JM Campochiaro PA VEGF is major stimulator in model of choroidal neovascularization. Invest Ophthalmol Vis Sci. 2000; 41: 3158-3164 PubMed Google Scholar Recently, therapies using recombinant anti-VEGF antibody fragments (eg, ranibizumab, bevacizumab, and aflibercept) 3 Lynch SS Cheng CM Bevacizumab for neovascular ocular diseases. Ann Pharmacother. 2007; 41: 614-625 Crossref PubMed Scopus (139) Google Scholar , 4 Rosenfeld PJ Rich RM Lalwani GA Ranibizumab: phase III clinical trial results. Ophthalmol Clin North Am. 2006; 19: 361-372 PubMed Scopus (287) Google Scholar , 5 Schmidt-Erfurth U Kaiser PK Korobelnik JF et al. Intravitreal aflibercept injection for neovascular age-related macular degeneration: ninety-six-week results of the VIEW studies. Ophthalmology. 2014; 121: 193-201 Summary Full Text Full Text PDF PubMed Scopus (602) Google Scholar to inhibit VEGF activity have shown that wet AMD can be treated successfully. However, the necessity for frequent intravitreal injections at 4–8 week intervals is expensive, 6 Levison D Medicare payments for drugs used to treat wet age-related macular degeneration. Department of Health and Human Services, Washington, DC2012 Google Scholar inconvenient for the patient, and carries the risk of infections such as endophthalmitis. 7 Day S Acquah K Mruthyunjaya P Grossman DS Lee PP Sloan FA Ocular complications after anti-vascular endothelial growth factor therapy in Medicare patients with age-related macular degeneration. Am J Ophthalmol. 2011; 152: 266-272 Summary Full Text Full Text PDF PubMed Scopus (129) Google Scholar Intravitreous injection of AAV2-sFLT01 in patients with advanced neovascular age-related macular degeneration: a phase 1, open-label trialIntravitreous injection of AAV2-sFLT01 seemed to be safe and well tolerated at all doses. Additional studies are needed to identify sources of variability in expression and anti-permeability activity, including the potential effect of baseline anti-AAV2 serum antibodies. Full-Text PDF

Prevalence of age‐related macular degeneration in the AGES ‐ Reykjavik Study

Abstract Purpose To determine the prevalence of age‐related macular degeneration in the Age, Gene/Environment Susceptibility ‐ Reykjavik Study. Methods The random sample includes individuals born between 1907 and 1935 who were recruited to participate from 2002‐2006. 5272 participated in the 3rd follow‐up visit which included an eye examination. After a maximum dilatation of the pupil all had a digital fundus photography centered on the macula. The photographs were graded by masked graders at the Wisconsin Ocular Epidemiology Grading Center using a modification of the Wisconsin Age‐related Maculopathy Grading System. Results The participants were 67 years and older. There were 5138 right macular fundus photographs gradable for early age‐related maculopathy (ARM). The prevalence of early ARM was 18.3% (95% CI 17.3‐18.9). Among the participants 4.4% (95% CI 3.9‐4.7) had late age‐related macular degeneration (AMD). For pure geographic atrophy (GA) there were 5036 gradable photographs of the right macula and the prevalence was 2.1% (95% CI 1.7‐2.3). Those with GA and also exudative AMD (mixed type) are not included in this category. For exudative late AMD there were 5152 gradable photographs of the right macula and the prevalence was 2.3% (95% CI 1.9‐2.5). GA, when present, was located in the centre circle (foveal area) in the vast majority of cases. Conclusion We found a steep age‐related increase in the prevalence of age‐related maculopathy in this elderly white population and geographic atrophy was usually located in the foveal area. The prevalence was similar for both late types of age‐related macular degeneration.

Prevalence of Age-Related Maculopathy and Age-Related Macular Degeneration among the Inuit in Greenland: The Greenland Inuit Eye Study

To examine the age- and gender-specific prevalence and describe the common phenotype of early age-related maculopathy (ARM) and late-stage age-related macular degeneration (AMD) among the Inuit in Greenland. Population-based cross-sectional study. All > or =60-year-olds born in Greenland and living in the communities of Nuuk and Sisimiut, Greenland. The presence and form of early (ARM) and late age-related macular disease (AMD) were determined by grading color fundus photographs using the international classification and grading system for ARM and AMD. Prevalences of ARM and AMD were assessed by masked grading of fundus photographs. Overall, 695 persons were included in the study (response rate, 74.8%). Prevalence of any ARM was 52.3%. Age-related maculopathy was present in the worse eye in 50.0%, 58.8%, and 44.7% of age groups 60 to 69, 70 to 79, and > or =80, respectively. Prevalence of any AMD was 9.5%. Any AMD was present in the worse eye in 3.9%, 14.6%, and 43.2% of age groups 60 to 69, 70 to 79, and > or =80. Prevalences of pure geographic atrophy (GA) in one or both eyes, exudative degeneration in one or both eyes, and GA in one eye and exudative degeneration in the other eye were 2.3%, 6.1%, and 1.1%, respectively. The prevalence of ARM is higher than in most other populations studied, and the prevalence of AMD in the oldest age group is higher than in most other populations studied. The prevalence of exudative degeneration is higher than the prevalence of GA, in contrast to findings in some of the Nordic countries-particularly Iceland-and earlier observations in Greenland.

Ankle-Brachial Index and the Prevalence of Age-Related Maculopathy

To examine the association of ankle-brachial blood pressure index (ABI) with prevalence of age-related maculopathy (ARM). A cross-sectional cohort study. ABI was measured in 2447 subjects aged 53 to 97 years. ARM was determined from 30-degree color stereoscopic fundus photographs. Low ABI (< or =0.9) was present in 5.4% of subjects. Early ARM was present in 22.1% of subjects with and 18.8% without low ABI. Late ARM was present in 5.3% of subjects with and 1.7% without low ABI. This result was not statistically significant. Low ABI does not appear to be a risk factor for ARM.

Early Age-Related Maculopathy and Risk Factors of Cardiovascular Disease in Middle-Aged Lithuanian Urban Population

To assess the prevalence of age-related maculopathy (ARM) in a middle-aged urban population and the relationship between ARM and the main risk factors of cardiovascular disease (CVD). The survey according to the WHO MONICA study protocol was carried out in Kaunas city, Lithuania, from 2001 to 2002. A total of 1403 persons aged 35 to 64 years were screened (626 men and 777 women: response rate 62.4%). Ophthalmologic investigation was performed for 1337 respondents (594 men and 743 women). Analysis of the relationship between ARM and risk factors of CVD was performed in case-control subdivision matching for sex, age, and education level. Early ARM was diagnosed in 7.4% of men and 5.4% of women. Rate of current smoking in case and control groups did not differ in men but in case group of women it was greater than in control group. Mean systolic and diastolic blood pressure and body mass index (BMI) in male case group and mean fasting blood glucose concentration in female case group were higher than in corresponding control groups. Frequency of diastolic hypertension (diastolic blood pressure > or = 90 mmHg) and obesity (BMI > or = 30 kg/m2) in male case group was higher than in control group. ARM was not associated with cholesterol and triglyceride levels in men and women. Early ARM in middle-aged Lithuanian urban population was associated with current smoking in women but not in men; it was associated with diastolic blood pressure and BMI in men and with fasting glucose level in women.

Prevalence study of age-related macular degeneration in Caojiadu blocks, Shanghai

To investigate the prevalence of age-related maculopathy (AMD) in Shanghai residents older than 50 years. 1023 individuals were examined in the years 2002 and 2003 for clinical and subjective signs of dry and exudative AMD. A interview concerning clinical symptoms of AMD as also a complete eye exam was performed. Non-mydriatic retinoscopy was done by use of a direct opthalmoscopy. Fundus photography was used to confirm and document the diagnosis. The diagnosis of both forms of AMD was made according to the criteria of the Sub-society of Fundus Disease, Chinese Ophthalmological Society. 15.5% of the included population had AMD and 19 of them were exudative AMD. The prevalences of AMD in the age groups of 50-59, 60-69, 70-79 and more than 80 were identified as 5.7%, 13.5%, 20.2% and 23.5%, respectively (chi(2) = 27.97, P < 0.01). No statistical differences were found concerning atrophic and exudative AMD related to gender, education, daily focus time, smoking, alcohol consumption and systematic diseases. In the AMD patients, 5.1% and 36.2% of the eyes were identified as blind or with low vision. In exudative AMD patients, 23.3% and 63.3% of the eyes were identified as blind or with low vision. The visual acuity of eyes with exudative AMD was significantly lower than the visual acuity of atrophic AMD eyes. (chi(2) = 15.4, P < 0.01). The prevalence of AMD is high, and increasing with aging. The AMD, especially the exudative AMD, leads to severe visual impairment.

Angiotensin-converting enzyme inhibitors (ACEIs) and age-related maculopathy (ARM): cross-sectional findings from the Blue Mountains Eye Study.

To assess the relationship between the use of angiotensin-converting enzyme inhibitors (ACEIs) and prevalence of age-related maculopathy (ARM). Eligible residents aged >/= 49 years were first examined in 1992-94 (Cross-section 1, n = 3654). Of these, 2335 were re-examined in 1997-99, together with an additional 1174 who became eligible after 1994 (Cross-section 2, n = 3509). Information regarding ACEI use was obtained and retinal photographs were graded using the Wisconsin ARM Grading System. In Cross-section 1, prevalence rates of late and early stage ARM were 1.3% and 4.3% among current ACEI users, and 2.0% and 4.8% among non-current users, respectively. In Cross-section 2, prevalence rates of late and early stage ARM were 2.3% and 11.3% among current ACEI users, and 1.3% and 9.3% among non-current users, respectively. After adjusting for age, sex and smoking, neither survey found any significant association between ACEI use and prevalence of either late or early ARM. No significant cross-sectional associations were found between ACEI use and ARM prevalence in this population.

Birth cohort effect on prevalence of age-related maculopathy in the Beaver Dam Eye Study.

The number of people in the United States with age-related maculopathy is increasing in recent years because of increasing longevity. However, it is possible that a birth cohort effect, due to different levels of exposure to risk factors, may explain changes in the prevalence of age-related maculopathy by age. In this report, the authors utilize data from the population-based Beaver Dam Eye Study (1988-2000) to examine this possibility. They propose a strategy to handle issues of longitudinal measurements and risk factor adjustment for analyzing the birth cohort effect. Results from the analysis (after adjusting for known risk factors) showed an apparent independent birth cohort effect on age-related maculopathy. The authors also found a strong positive association between age-related maculopathy and age, when comparing participants from the same birth cohort. The birth cohort effect was the same across different age groups, except for early age-related maculopathy, where older age increased the association. Our findings demonstrate that the birth cohort effect is likely attributable to unmeasured risk factors for age-related maculopathy and limitations of risk factor measurements. Further study of possible unmeasured risk factors that cause the cohort effect may help us understand the etiology of the disease.

The prevalence of age-related maculopathy by geographic region and ethnicity.

The prevalence of age-related maculopathy (ARM) varies considerably in different locations and racial/ethnic groups around the world. At present there are insufficient data to determine whether it is likely that these differences in prevalence, especially for the early forms of ARM are due to variations in genetic and environmental factors or due to variations in age of the cohorts and methods used to ascertain and define ARM. In three population-based studies of whites living in Beaver Dam, Wisconsin, Blue Mountains, Australia, and Rotterdam, The Netherlands, in which similar methods of ascertainment and classification were used to detect and define ARM, late ARM was present in 1.2%, 1.4%, and 1.2% of the population less than 86 years of age, respectively. While data from clinical studies suggest that late ARM associated with choroidal neovascularization is rare in blacks compared with whites, some epidemiological studies suggest that late ARM may be similar in blacks and whites. There are still too few data from various ethnic/racial groups around the world and too few population-based data in older Hispanic and Asian populations to make meaningful comparisons. There is a need for further research into the distribution of ARM and its possible causes using similar methodologies to ascertain and define the disease. Further insights will be gained when genotypes associated with ARM are discovered.

Familial Aggregation of Age-related Maculopathy

Purpose To determine whether age-related maculopathy aggregates in families by evaluating whether its prevalence is higher among relatives of case subjects with age-related maculopathy compared with relatives of control subjects without age-related maculopathy. Methods Individuals with (n = 119) and without (n = 72) age-related maculopathy were identified. First-degree relatives of case and control probands (parents, siblings, or offspring) 40 years of age or older were asked whether they had ever been diagnosed with macular degeneration. Medical records of 177 case and 146 control relatives confirmed the presence or absence of age-related maculopathy. Results The prevalence of medical-record confirmed age-related maculopathy was significantly higher among first-degree relatives of case probands (23.7%) compared with first-degree relatives of control probands (11.6%) with an age-and sex-adjusted odds ratio (OR), 2.4; 95% confidence interval (CI), 1.2 to 4.7; P = .013. Relatives of 78 case probands with exudative disease had a significantly higher prevalence of maculopathy (26.9%) compared with relatives of the 72 unaffected control probands (11.6%) (adjusted OR, 3.1; 95% CI, 1.5 to 6.7; P = .003), whereas the prevalence of age-related maculopathy among relatives of 41 probands with dry maculopathy (19.2%) was slightly but not significantly higher (adjusted OR, 1.5; 95% CI, 0.6 to 3.7; P = .36). Conclusions The prevalence of age-related maculopathy among first-degree relatives of subjects with age-related maculopathy, particularly with exudative disease, is greater than among first-degree relatives of subjects without this disease. Results suggest that macular degeneration has a familial component and that genetic or shared environmental factors, or both, contribute to its development.

Prevalence of age-related maculopathy at two points in time in an elderly British population.

As the demography of Western society changes, the population prevalence of diseases such as age-related macular degeneration (AMD) is expected to rise. Despite this, there remains a paucity of quality data concerning the population prevalence of AMD, the commonest cause of blindness in the elderly. To report the prevalence of AMD at two points in time in an elderly population. A geographically defined random population sample of elderly people was defined in 1980, and studied in 1982-4. In 1990, a cohort of survivors was identified. Participants underwent full ophthalmic examination with fundus photography using the same camera on each occasion. Photographs were randomly encoded and graded by two independent masked observers using the Wisconsin Age-related Maculopathy Grading System. Disagreements were resolved by consensus. Eighty-eight survivors participated in the follow-up examinations. Of these, 82 subjects had gradable retinal photographs for both examination points in at least one eye. There were 158 pairs of images (initial and subsequent) available for analysis. The mean age was 80 years (range 77-90 years) at the initial examination, and 87 years (range 84-97 years) at the subsequent examination; 70.7% of subjects were female. Prevalence rates for the initial examination were: drusen 72.8%, drusen confluence 37.3%, degeneration of the retinal pigment epithelium (RPE) 51.3%, increased pigment 22.2%, exudative AMD 1.9% and geographic atrophy 1.9%. Rates at second examination were: drusen 62.7% drusen confluence 41.8%, RPE degeneration 72.8%, increased pigment 16.5%, exudative AMD 3.8% and geographic atrophy 3.2%. This 'double' prevalence study provides detailed data on AMD lesions at two points in time in a population-based group of elderly people.

Familial Aggregation of Age-related Maculopathy

To determine whether age-related maculopathy aggregates in families by evaluating whether its prevalence is higher among relatives of case subjects with age-related maculopathy compared with relatives of control subjects without age-related maculopathy. Individuals with (n = 119) and without (n = 72) age-related maculopathy were identified. First-degree relatives of case and control probands (parents, siblings, or offspring) 40 years of age or older were asked whether they had ever been diagnosed with macular degeneration. Medical records of 177 case and 146 control relatives confirmed the presence or absence of age-related maculopathy. The prevalence of medical-record confirmed age-related maculopathy was significantly higher among first-degree relatives of case probands (23.7%) compared with first-degree relatives of control probands (11.6%) with an age- and sex-adjusted odds ratio (OR), 2.4; 95% confidence interval (CI), 1.2 to 4.7; P = .013. Relatives of 78 case probands with exudative disease had a significantly higher prevalence of maculopathy (26.9%) compared with relatives of the 72 unaffected control probands (11.6%) (adjusted OR, 3.1; 95% CI, 1.5 to 6.7; P = .003), whereas the prevalence of age-related maculopathy among relatives of 41 probands with dry maculopathy (19.2%) was slightly but not significantly higher (adjusted OR, 1.5; 95% CI, 0.6 to 3.7; P = .36). The prevalence of age-related maculopathy among first-degree relatives of subjects with age-related maculopathy, particularly with exudative disease, is greater than among first-degree relatives of subjects without this disease. Results suggest that macular degeneration has a familial component and that genetic or shared environmental factors, or both, contribute to its development.

Prevalence of Age-related Maculopathy: The Beaver Dam Eye Study

The relationships of retinal drusen, retinal pigmentary abnormalities, and macular degeneration to age and sex were studied in 4926 people between the ages of 43 and 86 years who participated in the Beaver Dam Eye Study. The presence and severity of various characteristics of drusen and other lesions typical of age-related maculopathy were determined by grading stereoscopic color fundus photographs using the Wisconsin Age-Related Maculopathy Grading System. One or more drusen were present in the macular area of at least 1 eye in 95.5% of the population. People 75 years of age or older had significantly higher frequencies (P less than 0.01) of the following characteristics than people 43 to 54 years of age: larger sized drusen (greater than or equal to 125 microns, 24.0% versus 1.9%), soft indistinct drusen (23.0% versus 2.1%), retinal pigment abnormalities (26.6% versus 7.3%), exudative macular degeneration (5.2% versus 0.1%), and geographic atrophy (2.0% versus 0%). These data indicate signs of age-related maculopathy are common in people 75 years of age or older and may pose a substantial public health problem.