Elsevier

Ophthalmology

Volume 109, Issue 6, June 2002, Pages 1092-1097
Ophthalmology

Five-year incidence of age-related maculopathy lesions: The blue mountains eye study

Presented in part at the annual meeting of the Association for Research in Vision and Ophthalmology, Fort Lauderdale, Florida, May 2000.
https://doi.org/10.1016/S0161-6420(02)01055-2Get rights and content

Abstract

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 noninclusion of intermediate soft drusen in the soft distinct and indistinct drusen categories.

Section snippets

Materials and methods

The Blue Mountains Eye Study (BMES) is a population-based survey of vision and common eye diseases in an urban population aged 49 years or older, resident in two postcodes of the Blue Mountains region, west of Sydney, Australia. The survey methods and procedures have been previously described.2, 9 The Study was approved by the Western Sydney Area Health Service Human Ethics Committee and signed informed consent was obtained from all participants. A detailed questionnaire was administered and

Results

Before commencement of the BMES II during 1997 to 1999, 543 participants (14.9%) died and 383 (10.5%) had moved from the study area. There were 2335 BMES I participants (75.1% of survivors) who attended BMES II, whereas 393 (10.8%) refused to participate. Table 1 compares baseline characteristics of participants seen (n = 2335) and not seen (n = 776) in BMES II. The BMES I participants who moved from the area or who refused to participate in BMES II were more likely at baseline to be older

Discussion

The current report provides data on the incidence of age-related maculopathy lesions from a large, older white population, using almost identical methodology and grading to that used in the Beaver Dam Eye Study. In both studies, retinal signs were documented with stereo retinal photographs, and ARM lesions were graded using compatible protocols and manners. This permits a direct comparison between the two studies.

We were able to follow 75% of the survivors from this aging study cohort (mean age

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Supported by the Australian National Health & Medical Research Council, Canberra, Australia (Grant No. 974159).

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