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R. Klein, S.C. Tomany, K.J. Cruickshanks, B.E. Klein; Sunlight and the 10-year Incidence of Age-related Maculopathy. The Beaver Dam Eye Study . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2109.
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Purpose: To examine the association between sunlight exposure and indicators of sun sensitivity with the 10-year incidence of age-related maculopathy (ARM). Methods: Included 4,926 persons 43 to 86 years of age at baseline examination in 1988 to 1990, living in Beaver Dam, Wisconsin, of whom 3,684 persons participated in a 5-year and 2,764 participated in a 10-year follow-up examination. Data on sun exposure and indicators of sun sensitivity were obtained from a standardized questionnaire. ARM status was determined by grading stereoscopic color fundus photos using the Wisconsin Age-Related Maculopathy Grading System. Results: While controlling for age and gender, exposure to summer sun for more than 5 hours per day during the teens, 30s, and at baseline was associated with the 10-year incidence of increased retinal pigment (RR: 3.17; 95% CI: 1.24,8.11, p-value=0.01) and early ARM (RR:2.14; 95% CI: 0.99,4.61, p-value=0.05) compared to those exposed less than two hours per day in the same time periods. Participants who experienced 2 to 10 burns in youth (n=1525) were significantly more likely to develop late ARM (RR: 2.32; 95% CI: 1.01,5.31; p-value=0.05) than those who experienced fewer severe burns in youth (n=1996). These relationships remained after controlling for vitamin use, smoking, and cataract status at baseline. UV-B exposure, use of hats and sunglasses, and skin sensitivity at baseline were not associated with the 10-year incidence or progression of ARM. Conclusion: These data, consistent with the previously published five-year findings, demonstrate an increased risk of developing ARM in those exposed to sunlight. Sunlight exposure may not be a factor in the transition from early to late stage disease.
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