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Fifteen-year cumulative incidence of age-related macular degeneration: the Beaver Dam Eye Study.
Ophthalmology. 2007 Feb; 114(2):253-62.O

Abstract

PURPOSE

To describe the 15-year cumulative incidence of signs of early and late age-related macular degeneration (AMD).

DESIGN

Population-based cohort study.

PARTICIPANTS

We included 3917 persons, 43 to 86 years of age at the time of a baseline examination in 1988 through 1990 and with information collected in follow-up in 1993 through 1995, and/or 1998 through 2000, and/or 2003 through 2005.

METHODS

Grading of stereoscopic fundus photographs using the Wisconsin Age-Related Maculopathy Grading System.

MAIN OUTCOME MEASURES

Cumulative incidence of drusen type and size, pigmentary abnormalities, geographic atrophy, and exudative AMD accounting for competing risk of death.

RESULTS

The 15-year cumulative incidence was 14.3% for early AMD (the presence of either soft indistinct drusen or the presence of pigmentary abnormalities together with any type of drusen) and 3.1% for late AMD (presence of exudative AMD or geographic atrophy). There was an increased incidence of AMD lesions with age (P<0.05). Individuals > or = 75 years of age at baseline had significantly (P<0.01) higher 15-year incidences of the following characteristics than people 43 to 54 years of age: larger drusen (125 mum in diameter, 24.1% vs 10.6%), soft indistinct drusen (18.7% vs 6.5%), retinal pigmentary abnormalities (20.2% vs 3.7%), exudative macular degeneration (4.4% vs 0.4%), and pure geographic atrophy (3.2% vs 0%). Controlling for age, compared with those with small numbers of only small hard drusen (1-2), those with large numbers of only hard drusen (> or =8) had an increased 15-year age-adjusted incidence of both soft indistinct drusen (16.3% vs 4.7%) and pigmentary abnormalities (10.6% vs 2.7%). Eyes with soft indistinct drusen or pigmentary abnormalities at baseline were more likely to develop late AMD at follow-up than eyes without these lesions (17.8% vs 1.2% and 12.9% vs 1.7%, respectively).

CONCLUSIONS

We document the long-term incidence of signs of AMD and a continuum from small hard drusen to late AMD in older persons in the population. The 15-year cumulative incidence of late AMD in people > or = 75 years of age (8%) indicates a public health problem of significant proportions because the United States population this age is expected to increase by 54% between 2005 and 2025.

Authors+Show Affiliations

Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53726-2336, USA. kleinr@epi.ophth.wisc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17270675

Citation

Klein, Ronald, et al. "Fifteen-year Cumulative Incidence of Age-related Macular Degeneration: the Beaver Dam Eye Study." Ophthalmology, vol. 114, no. 2, 2007, pp. 253-62.
Klein R, Klein BE, Knudtson MD, et al. Fifteen-year cumulative incidence of age-related macular degeneration: the Beaver Dam Eye Study. Ophthalmology. 2007;114(2):253-62.
Klein, R., Klein, B. E., Knudtson, M. D., Meuer, S. M., Swift, M., & Gangnon, R. E. (2007). Fifteen-year cumulative incidence of age-related macular degeneration: the Beaver Dam Eye Study. Ophthalmology, 114(2), 253-62.
Klein R, et al. Fifteen-year Cumulative Incidence of Age-related Macular Degeneration: the Beaver Dam Eye Study. Ophthalmology. 2007;114(2):253-62. PubMed PMID: 17270675.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fifteen-year cumulative incidence of age-related macular degeneration: the Beaver Dam Eye Study. AU - Klein,Ronald, AU - Klein,Barbara E K, AU - Knudtson,Michael D, AU - Meuer,Stacy M, AU - Swift,Maria, AU - Gangnon,Ronald E, PY - 2006/06/07/received PY - 2006/10/26/revised PY - 2006/10/26/accepted PY - 2007/2/3/pubmed PY - 2007/2/21/medline PY - 2007/2/3/entrez SP - 253 EP - 62 JF - Ophthalmology JO - Ophthalmology VL - 114 IS - 2 N2 - PURPOSE: To describe the 15-year cumulative incidence of signs of early and late age-related macular degeneration (AMD). DESIGN: Population-based cohort study. PARTICIPANTS: We included 3917 persons, 43 to 86 years of age at the time of a baseline examination in 1988 through 1990 and with information collected in follow-up in 1993 through 1995, and/or 1998 through 2000, and/or 2003 through 2005. METHODS: Grading of stereoscopic fundus photographs using the Wisconsin Age-Related Maculopathy Grading System. MAIN OUTCOME MEASURES: Cumulative incidence of drusen type and size, pigmentary abnormalities, geographic atrophy, and exudative AMD accounting for competing risk of death. RESULTS: The 15-year cumulative incidence was 14.3% for early AMD (the presence of either soft indistinct drusen or the presence of pigmentary abnormalities together with any type of drusen) and 3.1% for late AMD (presence of exudative AMD or geographic atrophy). There was an increased incidence of AMD lesions with age (P<0.05). Individuals > or = 75 years of age at baseline had significantly (P<0.01) higher 15-year incidences of the following characteristics than people 43 to 54 years of age: larger drusen (125 mum in diameter, 24.1% vs 10.6%), soft indistinct drusen (18.7% vs 6.5%), retinal pigmentary abnormalities (20.2% vs 3.7%), exudative macular degeneration (4.4% vs 0.4%), and pure geographic atrophy (3.2% vs 0%). Controlling for age, compared with those with small numbers of only small hard drusen (1-2), those with large numbers of only hard drusen (> or =8) had an increased 15-year age-adjusted incidence of both soft indistinct drusen (16.3% vs 4.7%) and pigmentary abnormalities (10.6% vs 2.7%). Eyes with soft indistinct drusen or pigmentary abnormalities at baseline were more likely to develop late AMD at follow-up than eyes without these lesions (17.8% vs 1.2% and 12.9% vs 1.7%, respectively). CONCLUSIONS: We document the long-term incidence of signs of AMD and a continuum from small hard drusen to late AMD in older persons in the population. The 15-year cumulative incidence of late AMD in people > or = 75 years of age (8%) indicates a public health problem of significant proportions because the United States population this age is expected to increase by 54% between 2005 and 2025. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/17270675/Fifteen_year_cumulative_incidence_of_age_related_macular_degeneration:_the_Beaver_Dam_Eye_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(06)01478-3 DB - PRIME DP - Unbound Medicine ER -