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Sherouk Gamal Saad, Samir I Sayegh; All Brown or all Dead? Towards the Determination of the Prevalence of Age Related Macular Degeneration in Egyptians.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):13. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the prevalence of age related macular degeneration (AMD) in a low income population in Northern Egypt to a higher income population at an Eye clinic in the Midwest USA.
This is an observational pilot study, 781 patients participated as they presented to the general ophthalmic clinic in El-Mataria teaching hospital (Northern Egypt). A subset of the patients were referred to the Retina clinic due to abnormal finding on fundus examination.Data about age, gender, comorbidites and smoking status were collected from all participants. Patients referred to the Retina clinic were examined for the presence of drusen, retinal pigment epithlium (RPE) abnormalities, geographic atrophy and choroidal neovascularization (CNV) on fundus examination according to the AREDS classification system of AMD.The same was done in the Eye clinic in Illinois (USA) in addition to selective use of OCT and FFA and/or ICG angiography. The occurrence of AMD was compared in the two populations.
65% of the participants were females, 35% were males with 21.3% being ≥60 years. Nearly 6.6% were referred to the Retina clinic. Following the AREDS classification system of AMD, 0.25% of all participants were found to have early AMD (AREDS category 2) where a combination of multiple small drusen, few intermediate drusen (63 to 124 microns) and RPE abnormalities were detected on fundus examination.In the Midwestern clinic, statistics showed a much higher prevalence rate of AMD with 25% of visits carrying a diagnosis of AMD.
Participants in Northern Egypt appear to show lower risk factors of AMD in comparison to participants in a representative Eye clinic in the USA. A number of reasons are postulated for this discrepancy. Differences in life expectancies and smoking prevalence of the two populations as recorded by the World Health Organiszation (WHO) need be taken into account. Indeed the life expectancy for males in Egypt does not exceed 70 years of age and that for females does not exceed 75. Limited availability of OCT in the referring clinics, limited awareness of treatment options may contribute to undiagnosed cases of AMD.Racial factors may play a role. It is not clear how Egyptians can be related to specific races for which studies have been performed. Epidemiological and genetic studies will be needed to clarify the true prevalence and risk factors of AMD in Egypt.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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