Elsevier

Ophthalmology

Volume 107, Issue 8, 1 August 2000, Pages 1593-1600
Ophthalmology

The prevalence of age-related maculopathy: The visual impairment project1,

https://doi.org/10.1016/S0161-6420(00)00175-5Get rights and content

Abstract

Purpose

To determine the prevalence of age-related maculopathy (ARM) lesions in residents of the state of Victoria, Australia.

Design

Population-based cross-sectional study.

Participants

Total of 5147 residential and institutionalized persons aged 40 years and older, living in Victoria.

Methods

Participants were recruited through a cluster, stratified, random sampling from nine urban clusters and four rural clusters. The presence of ARM lesions was graded from color stereo fundus photographs as well as slit-lamp stereo biomicroscopy according to the International Classification and Grading System.

Main outcome measures

The presence of ARM lesions.

Results

The mean age of participants was 60.2 years, and 55% were females. Gradable fundus photographs were available for at least one eye in 4345 (92%) of the participants. The weighted prevalence of neovascular age-related macular degeneration (AMD) was 0.39% (95% confidence limits [CL] = 0.20, 0.58), atrophic AMD was 0.27% (95% CL = 0.04, 0.50), and total AMD was 0.68% (95% CL = 0.30, 1.1). Prevalence of AMD was strongly related to age (P < 0.001). Prevalence of early ARM was 15.1% (95% CL = 13.7, 16.4). Large drusen, 125 μm or more, were present in 6.3% of the participants. There was a higher prevalence of soft distinct drusen (7.5%) than soft indistinct drusen (4.3%). Retinal pigmentary abnormalities were present in 8.2% (95% CL = 7.2, 9.2). The prevalence of large drusen, soft drusen, and pigmentary abnormalities increased with age (P < 0.001). Prevalence of retinal pigmentary abnormalities increased with increasing drusen size (P < 0.001). Soft indistinct drusen were more common in women aged 70 years or older (P < 0.001). Bilaterality of any ARM was strongly age related, and women appeared to have a higher risk of both bilateral early ARM and AMD.

Conclusions

These data provide age- and gender-specific prevalence of ARM and its component lesions in an ethnically diverse Australian population. Early ARM and AMD prevalence rates increased sharply from ages 70 and 80 years, respectively, in all ethnic groups. These higher rates will continue to increase the importance of AMD as our population ages.

Section snippets

Study population

A detailed methodology for the VIP has been published previously.16 Briefly, the stratified cluster sample was drawn from nine randomly selected pairs of adjacent census collector districts in urban Melbourne and four pairs of randomly selected adjacent census collector districts in four rural communities in Victoria. A door-to-door household census was conducted to identify all eligible persons, defined as those aged 40 years and older in the calendar year of the examination who had lived at

Results

The mean age of participants was 60.2 years (standard deviation [SD] = 12.9 years; range, 40–102 years), 55% were females (Table 1), and 35% were born overseas: British (9%), Eastern Europe (4%), Greece (6%), Italy (8%), and others (9%).

Discussion

Unlike previous published reports, the VIP provides prevalence data on ARM from a sample population that includes both urban and rural residential adults 40 years and older. In this study population, 0.68% of the participants had signs of AMD in one or both eyes. Neovascular AMD in at least one eye was seen in 0.39% and atrophic AMD in 0.27%. However, the most striking finding is the overall 59% prevalence of any ARM and 23% prevalence of AMD in those more than 90 years.

To allow comparison with

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  • Cited by (0)

    The Visual Impairment Project was funded in part by grants from the National Health and Medical Research Council, Victorian Health Promotion Foundation, the estate of the late Dorothy Edols, Ophthalmic Research Institute of Australia, Ansell Ophthalmology Foundation, and Jack Brockhoff Foundation.

    1

    Received December 30, 1999. Accepted March 27, 2000.

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