June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
The Incidence and Progression of Reticular Drusen: Findings from an Older Australian Cohort
Author Affiliations & Notes
  • Nichole Joachim
    Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia
  • Paul Mitchell
    Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia
  • Elena Rochtchina
    Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia
  • Ava Tan
    Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia
  • Jie Jin Wang
    Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia
    Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC, Australia
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 367. doi:
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      Nichole Joachim, Paul Mitchell, Elena Rochtchina, Ava Tan, Jie Jin Wang; The Incidence and Progression of Reticular Drusen: Findings from an Older Australian Cohort. Invest. Ophthalmol. Vis. Sci. 2013;54(15):367.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To assess 15-year incidence of reticular drusen (RDR) and their associations with known age-related macular degeneration (AMD) risk factors in an older Australian cohort.

 
Methods
 

The Blue Mountains Eye Study examined 3654 participants aged 49+ years at baseline (1992-94), and re-examined 75.8, 76.5 and 56.1% of survivors 5, 10 and 15 years later, respectively. Retinal photographs were taken at each visit and DNA samples genotyped. Incidence and progression of RDR were confirmed using side-by-side grading from colour photographs. Incidence was estimated using the Kaplan-Meier product-limit survival method, controlling for competing risk of death. Associations between incidence of RDR and smoking, fish consumption, serum lipids, white cell count, and CFH-rs1061170 and ARMS2-rs10490924 single nucleotide polymorphisms were analyzed using discrete logistic regression models adjusting for age and sex.

 
Results
 

The 15-year cumulative incidence of RDR was 4.0% (n=95); increasing from 0.4% in the age group 49-54 years to 7.0% in those aged 65-74 years, and then decreasing to 4.9% in those aged 75+ years (P for trend <.0001). Women had a higher incidence of RDR compared to men (5.6% versus 2.2%, P=0.003). Increasing age (per decade; odds ratio, OR, 3.4; 95% confidence interval, CI, 2.6-4.4), female sex (OR 2.0, 95% CI 1.3-3.2) and presence of each risk allele of CFH (OR 1.8, 95% CI 1.3-2.4) or ARMS2 (OR 3.0, 95% CI 2.1-4.4) were associated with increased risk of developing RDR. Baseline current smokers had a significantly higher risk of RDR (OR 2.1, 95% CI 1.0-4.5) after adjusting for age, sex, and CFH and ARMS2 polymorphisms. Of 218 eyes with RDR (prevalent and incident cases), 40 eyes (18.4%) developed late AMD in 5 years (neovascular AMD 42.5%; geographic atrophy 57.5%). Total area of RDR or RDR extending to a near central location was found not to be associated with progression to late AMD in 5 years. A higher proportion of eyes with RDR located outside the macular area progressed to late AMD (36.4%), compared to those with RDR involving the macula area (10.1 and 22.2% for RDR within inner and outer subfields of the Wisconsin Grading grid, respectively).

 
Conclusions
 

Known AMD risk factors were associated with increased long-term risk of developing RDR. RDR area and location were not associated with progression to late AMD over 5 years.

 
Keywords: 504 drusen • 412 age-related macular degeneration • 463 clinical (human) or epidemiologic studies: prevalence/incidence  
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