Age-Related Maculopathy, Retinopathy and Other Retinal Diseases in French Elderly Subjects: The Alienor Study

Abstract

Purpose: : To describe the prevalence of retinal diseases in a sample of French subjects aged 73 years or more.

Methods: : Subjects are being recruited from a population-based cohort study on the vascular risk factors of dementia. Subjects were initially aged 65 years or more, recruited in the city of Bordeaux, France in 1999-2001 and followed up every 2 years since. The ALIENOR (Antioxydants, LIpides Essentiels, Nutrition et maladies OculaiRes) study consists in an eye examination, simultaneous to the third, ongoing, follow-up examination. Currently, retinal data are available for 408 subjects. The total expected number of subjects is 1000. Retinal diseases were classified on the basis of non-mydriatic digital photographs of the macula, according to the International Classification of Age-Related Maculopathy (ARM). The photographs were interpreted in double by two trained technicians and adjudicated by a specialist when inconsistent. All cases of late ARM were confirmed by a retinal specialist. Late ARM was defined by the presence of neovascular ARM and/or geographic atrophy. Early ARM was defined by the presence of large soft drusen (>125 microns) and/or the presence of pigmentary abnormalities (hyper- or hypo-pigmentation) associated with soft drusen (>63 microns), in the absence of late ARM. Retinopathy was defined by the presence of microaneurysms and/or retinal hemorrhage.

Results: : Among the first 408 included subjects, 371 (90.9 %) had gradable photographs. Mean age was 79.6 years (SD : 4.2 years). Prevalence of early and late ARM were 21.8 % (95 % confidence interval (CI) : 17.6% - 26.0 %) and 4.6 % (95 % CI : 2.5 % - 6.7 %). Prevalence of early and late ARM was not different in men and women, but increased with age : 19.8 % and 2.4 % in subjects younger than 80 years versus 24.5 % and 7.6 % in subjects older than 80 years, respectively (p=0.02). Prevalence of retinopathy was 8.9 % (95 % CI: 6.0 % - 11.8 %) and was not significantly associated with age or gender. We also observed 4 cases of vein occlusion (central or branch) (1.1 %) and 12 cases of epiretinal membrane (3.2 %).

Conclusions: : The prevalence rates of major retinal diseases observed in this sample are similar to those usually observed in elderly subjects of Western countries, supporting the hypothesis that our sample is not highly biased.

Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • aging • age-related macular degeneration