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R Van Leeuwen, CC W Klaver, JR Vingerling, A Hofman, PT V M de Jong; Risk and Prognosis of Age-Related Maculopathy: 7-Years Follow-up in the Rotterdam Study . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3964.
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Purpose: To report the incidence of early and late age-related maculopathy (ARM) and to describe the progression and predictive value of early ARM fundus features. Methods: Participants from the population-based Rotterdam Study underwent a full ophthalmologic screening. Stereo color transparencies were graded at baseline and follow-up with identical protocol and graders. Diagnosis of ARM was based on the International Classification System. At baseline, a total of 6312 subjects, aged 55-99 years, were at risk for late ARM, also called age-related macular degeneration (AMD). Results: After a mean period of 6.5 years, 3620 subjects had participated in the third examination. The overall incidence rate of AMD was 1.3 per 1000 person-years (5-year cumulative incidence 0.7%). The ratio of neovascular macular degeneration over geographic atrophy was 1.3. No significant gender difference was found. The overall incidence rate of early ARM was 12.4 per 1000 person-years (5-year risk 6.0%). The 5-year risk of subjects with early ARM to develop AMD was 9.1%. The most important prognostic fundus features for the incidence of late ARM were more than 10% of grid area covered by drusen, soft indistinct drusen, and more than 10 large drusen. Conclusion: The population-based incidence of early and late ARM increases with age. The results seem to confirm previous prevalence data that showed that ARM is less common in an European population compared with an US population. Subjects who develop AMD show a clear change in total drusen area and drusen morphology.
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