Associations Between Refraction, Prevalent and Incident Age-related Maculopathy: The Rotterdam Study

Abstract

Abstract: : Purpose: There seems to be a lower prevalence of age-related maculopathy (ARM) in myopic eyes. If so this could lead to knew hypotheses about pathogenesis. The purpose was to study the relationship between baseline spherical equivalents (SphE) of refraction and prevalent and incident early ARM (pARM and iARM) as well as prevalent and incident late ARM or age-related macular degeneration (pAMD and iAMD). Methods: The value for SphE in diopters measured with autorefraction followed by subjective correction was taken of one eye of 6209 subjects aged 55 years and older. Aphakic or pseudo-phakic eyes at baseline were excluded. Color fundus transparencies were graded according to the International ARM Classification system and eyes were classified in three grades from 0 (drusen < 63 :m), 1 early ARM and 2 AMD. For prevalence analyses, per subject the eye with the highest pARM grade was selected. After a mean 6.5 years of follow-up, 3514 subjects had complete data for our incidence analyses. In these analyses, per subject the eye with most marked progression of ARM was selected. Results: The relative risk (RR) for early pARM (n = 440) for every diopter towards hyperopia was 1.09 (95% CI 1.04-1.14) and for pAMD (n = 96) 1.09 (1.00-1.19). For early iARM (n = 279) and iAMD (n = 37) these RR's were 1.08 (1.02-1.14) and 0.98 (0.87-1.11), respectively. For hyperopia >= +3.0 D the RR for early pARM was 1.62 (1.12-2.34) and for early iARM 1.42 (0.93-2.17). Conclusions: These population-based incidence data conform data from prevalence and case-control studies that there is an association between hyperopia and ARM.

Keywords: age-related macular degeneration • refraction • pathobiology