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Prevalence and determinants of age-related macular degeneration in central Sri Lanka: the Kandy Eye Study
  1. L A Goold1,
  2. K Edussuriya2,
  3. S Sennanayake2,
  4. T Senaratne2,
  5. D Selva1,
  6. T R Sullivan3,
  7. R J Casson1
  1. 1South Australian Institute of Ophthalmology, Adelaide, South Australia, Australia
  2. 2Kandy Centre for Save Sight, Kandy, Sri Lanka
  3. 3Discipline of Public Health, University of Adelaide, Adelaide, South Australia, Australia
  1. Correspondence to Dr L A Goold, South Australian Institute of Ophthalmology, North Terrace, Adelaide, South Australia, Australia 5000; lgoold{at}


Aims To determine the prevalence, associations and risk factors for age-related macular degeneration (ARMD) in central Sri Lanka.

Methods The study was a population-based, cross-sectional survey of residents aged ≥40 years in rural Sri Lanka. ARMD was assessed on dilated fundoscopy using the International Age-Related Maculopathy Epidemiology Study Group classification system.

Results Of the 1721 subjects identified, 1375 participated (79.9%). Of the participants, 1013 were aged ≥50 years (73.6%). The prevalence of any ARMD (adjusted for study design) was 4.72 (95% CI 2.22 to 7.20)% with 3.82 (95% CI 1.60 to 6.04)% early ARMD and 1.70 (95% CI 0.14 to 3.27)% late ARMD. Age (p<0.001) and Sinhalese ethnicity (p = 0.016) were significantly associated with ARMD. Men had a tendency toward a higher prevalence of ARMD than women, although this was not statistically significant (p = 0.081). Ocular risk factors such as cortical cataract (p = 0.024) and pseudophakia (p = 0.003) were associated with ARMD on the univariate but not multivariate analyses. Illiteracy and the identification of social supports were significantly associated with ARMD on univariate analyses. However, only social support was statistically significant after multivariate analysis (p = 0.024).

Conclusions Although the prevalence of ARMD is slightly lower in Sri Lanka than surrounding regions, it contributes to a higher proportion of visual impairment, including blindness. Risk factors include age and Sinhalese ethnicity.

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  • Funding The Kandy Eye Study was supported financially from an unrestricted grant from Pfizer.

  • Competing interests None declared.

  • Ethics approval The Kandy Eye Study had ethical approval from the Royal Adelaide Hospital Ethics Committee. The study was conducted in accordance with the Declaration of Helsinki.

  • Patient consent Consent for participation was obtained from the head of each village prior to commencement of the survey. Informed consent, in the participant's own language, was obtained from all participants.

  • Provenance and peer review Not commissioned; externally peer reviewed.