Abstract
Abstract: :
Purpose:to describe the 14½–year incidence and changes in appearance of retinal drusen, pigment abnormalities, and late age–related maculopathy (ARM) lesions. Methods: 946 residents, aged 60 to 80 years, living in Copenhagen, Denmark, participated in the study during 1986 to 1988. Excluding participants who had died since baseline, 359 persons (97.3% of survivors) were re–examined after 14½ years during 2000 to 2002. Participants underwent an extensive ophthalmologic examination. Characteristics of drusen and other signs of age–related maculopathy were determined and graded on color fundus photographs from both examinations using a modification of the Wisconsin ARM Grading System. Main Outcome Measures: Incidence of drusen type and size, early ARM (i.e. soft indistinct drusen or any drusen, except from hard indistinct drusen, and pigmentary abnormalities), and late ARM (i.e. geographic atrophy, and exudative macular degeneration) in the right eye. Results: The 14½–year incidence of early ARM was 31.5% and of late ARM 14.8%. There was an increased incidence with age of all age–related maculopathy lesions except from small drusen (<125µm in diameter) that decreased with age (test of trend, P <0.013). Individuals 75 to 80 years of age at baseline had significantly (P < 0.05) higher 14½–year incidences than people 60 to 64 years of age of the following lesions: large drusen (> 125 µm, 34.2% vs. 12.8%), soft drusen (45.2% vs. 21.4%), pigmentary abnormalities (31.4% vs. 17.0%), pure geographic atrophy (17.4 % vs. 1.0%) and exudative macular degeneration (23.3 % vs. 5.7%). Persons with larger drusen (>63µm) at baseline had an increased 14½–year incidence of early ARM (41.9% vs. 28.1%, P=0.05) compared with those with only small hard drusen (<63µm). Eyes with early ARM at baseline were more likely to develop late ARM at follow–up than eyes without these lesions (81.1% vs. 5.1%, P<0.001). Conclusions: The high incidence of age–related maculopathy lesions in elderly Scandinavian persons is documented in this study. Drusen size 63 µm or more in diameter predicts an increased incidence of soft drusen and pigmentary abnormalities. The presence of early ARM increases the risk for the development of late stage ARM lesions.
Keywords: age–related macular degeneration • clinical (human) or epidemiologic studies: prevalence/incidence