The epidemiology of age-related macular degeneration - 25/08/11

Doi : 10.1016/j.ajo.2003.11.069

Ronald Klein, MD, MPH ^a,^⁎ , Tunde Peto, MD,PhD ^b, Alan Bird, MD ^b, Mylan R. Vannewkirk, MD, MPH ^c
^a Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, Wisconsin, USA (R.K.)
^b Department of Clinical Ophthalmology, Institute of Ophthalmology, University College London, London University, London, United Kingdom (T.P., A.B.)
^c Ophthalmology Consultant, Southern Health Southland, Invercargill, New Zealand (M.R.V.)

^*Inquiries to Dr. Ronald Klein, MD, MPH, Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, 610 North Walnut Street, 417 WARF, Madison, WI 53726, USA; fax (608) 263-0279

Abstract

Purpose

To review the epidemiology of age-related macular degeneration (AMD).

Design

Evidence from epidemiologic data regarding the natural history of AMD and its risk factors are presented.

Results

Large, soft drusen associated with pigmentary abnormalities increase the risk of progression to advanced AMD. Large soft drusen may fade over time. Advanced AMD is more likely to be present in whites than blacks, despite the similar prevalence of soft drusen in both groups. Neovascular AMD is more frequent than geographic atrophy in most population-based studies in whites in America, Australia, and the Netherlands than in similar population-based studies in Iceland and Norway. After age and family history, there are few consistent relationships of risk factors to AMD. Of these, the relationship of smoking, hypertension, and cataract surgery to advanced AMD have been most consistent.

Conclusions

Long-term epidemiologic studies have provided information on the distribution and the natural history of AMD and its associated risk factors. It is not known what effect reduction of blood pressure and the cessation of smoking might have on the incidence and progression of AMD.

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