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A.E. Fletcher, G. Bentham, M. Rahu, J. Vioque, J. Seland, G. Soubrane, U. Chakravarthy, L. Tomazzoli, F. Topouzis, C. Augood; High Exposures to Sunlight are Associated With AMD . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3307.
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Purpose: To investigate the association between solar radiation (UVR) and its components (UVA, UVB and blue light) with age related maculopathy and macular degeneration in the seven country EUREYE study. Methods: 4760 randomly sampled people aged 65 and over participated in an eye examination and risk factor assessment. Fundus images were graded at a single reading centre using the International ARM Epidemiological Study Group classification and stratified into 5 exclusive stages based on the grading in the worst eye.Stage 4 (AMD) was characterised as neovascular or geographic atrophy. History of outdoor exposure was assessed by a questionnaire on lifetime residence, occupational and leisure time behaviour (all day and middle of the day ie11 am to 3 pm),use of protective eyewear and hats and mapped to meteorological data to provide personal exposures to UVA, UVB and blue light . Multiple logistic regression for cluster data was used. Results: Analyses adjusted for age, sex and smoking showed little evidence for an association of quintiles of light exposure and ARM grades 1, 2 and 3 compared to grade 0. There was a two fold association of high middle of the day light exposures with AMD in countries, apart from Spain . Different patterns were observed in analyses by type of AMD with increased odds for the highest quintile of exposure for neovascular but not for geographic AMD, eg for UVB, OR= 2.52 (95% CI 1.16, 4.44) p=0.02. There was little difference in the effects of type of light exposure i.e. whether UVA, UVB or blue light . These results were not materially affected by adjusting for vitamin C, lutein or zeaxanthein and associations were stronger in those with low plasma levels of these vitamins and high exposures to UVR. Conclusions: Our results provide evidence for the adverse effect of high sunlight exposure and support recommendations on ocular protection
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