Abstract
Despite age-related macular degeneration (AMD) being the commonest cause of blindness amongst the elderly in Western society, the incidence of new lesions is poorly documented and the natural history of existing disease remains ill understood.
Purpose: To document in an elderly population the incidence of new AMD lesions and the progression of pre-existing AMD over time.
Method: Baseline ophthalmic examinations were performed on a geographically defined random population sample of elderly people in 1982-4, and retinal photographs taken. The present study re-examined md re-photographed survivors after approximately 7 years using the same fundus camera. Photographs were randomly encoded, and independently graded for AMD features by two masked observers using the Wisconsin AMD grading system. Disagreements were resolved by review to reach a consensus.
Results: Eighty-two of the 88 participating survivors had photographs of gradable quality on both occasions in at least one eye. Mean age at follow-up was 87 years (range 84-97 years) and 70.7% of subjects were female. Paired photographs were available on 158 eyes, and showed important differences in drusen type, drusen area and characteristics of the retinal pigment epithe-lium (RPE) between initial and subsequent examinaions. The 7 year incidence (and regression) of lesions was: drusen 30.6% (20.0%), RPE degeneration 54.5% (8.8%), increased pigment 11.6% (64.7%), subretinal hemorrhage 1.3%, subretinal scar/fibrin 1.3% and cograpbic study 1.3%.
Conclusion: These unique population-based results provide new insight into the natural history of AMD in an elderly population.
Similar content being viewed by others
Article PDF
References
Green WR, McDonnell PJ, Yeo JH . Pathological features of senile macular degeneration. Ophthalmology 1985;92:615–27.
Vinding T . Age-related macular degeneration: macular changes, prevalence and sex ratio. An epidemiological study of 100 aged individuals. Acta Ophthalmol (Copenh) 1989;67:609–16.
Evans JR, Wormald RPL . Epidemiological function of BD8 certification. Eye 1993;7:172–9.
Cheraskin E . Macular degeneration: how big is the problem? J Natl Med Assoc 1992;84:873–6.
Bressler NM, Munoz B, Maguire MG, et al. Five year incidence and disappearance of drusen and retinal pigment epithelial abnormalities (Waterman study). Arch Ophthalmol 1995;113:301–8.
Gregor Z, Bird AC, Chisholm IH . Senile disciform macular degeneration in the second eye. Br J Ophthalmol 1977;61:141–7.
Bressler NM, Bressler SB, Seddon JM, Gragoudas ES, Jacobson LP . Drusen characteristics in patients with exudative versus non-exudative age-related macular degeneration. Retina 1988;8:109–14.
Bressler NM, Bressler SB, Fine SL . Age-related macular degeneration. Surv Ophthalmol 1988;32:375–413.
Klein R, Davis MD, Magli YL, Segal P, Klein BE, Hubbard L . The Wisconsin age-related maculopathy grading system. Ophthalmology 1991;98:1128–34.
Sparrow JM, Dickinson AJ, Duke AM . The Wisconsin Age-related Macular Degeneration Grading System: performance in an independent centre. Ophthalmic Epidemiol 1997;4:49–55.
Leibowitz HM, Krueger DE, Maunder LR, et al. The Framingham Eye Study Monograph. Surv Ophthalmol 1980;24(Suppl):335–610.
Martinez GS, Campbell AJ, Reinken J, Allan BC . Prevalence of ocular disease in a population study of subjects 65 years old and older. Am J Ophthalmol 1982;94:181–9.
Lui IY, White L, LaCroix AZ . The association of age-related macular degeneration and lens opacities in the aged. Am J Public Health 1989;79:765–9.
Clarke M, Clarke SM, Odell A, Jagger C . The elderly at home: health and social status. Health Trends 1984;16:3–7.
Dickinson AJ, Sparrow JM, Duke AM, Thompson JR, Gibson JM, Rosenthal AR . Prevalence of age-related macular degeneration at two time points in an elderly British population. Eye 1997;11:301–14.
Gibson JM, Rosenthal AR, Lavery J . A study of the prevalence of eye disease in the elderly in a community. Trans Ophthalmol Soc UK 1985;104:196–203.
Klein R, Klein BEK, Linton KLP . Prevalence of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology 1992;99:933–43.
Sarks SH . Ageing and degeneration in the macular region: a clinico-pathological study. Br J Ophthalmol 1976;60:324–41.
Sarks SH . Drusen and their relationship to senile macular degeneration. Aust J Ophthalmol 1980;8:117–30.
Coffey AJH, Brownstein S . The prevalence of macular drusen in postmortem eyes. Am J Ophthalmol 1986;102:164–71.
Lewis H, Straatsma BR, Foos RY . The prevalence of macular drusen in postmortem eyes. Am J Ophthalmol 1986;102:801–2.
van der Schaft TL, Mooy CM, de Bruijn WC, Oron FG, Mulder PG, de Jong PT . Histological features of the early stages of age-related macular degeneration: a statistical analysis. Ophthalmology 1992;99:278–86.
Sarks JP, Sarks SH, Killingsworth MC . Evolution of soft drusen in age-related macular degeneration. Eye 1994;8:269–83.
Sarks JP, Sarks SH, Killingsworth MC . Evolution of geographic atrophy of the retinal pigment epithelium. Eye 1988;2:552–77.
Schatz H, McDonald HR . Atrophic macular degeneration: rate of spread of geographic atrophy and visual loss. Ophthalmology 1989;96:1541–51.
Smiddy WE, Fine SL . Prognosis of patients with bilateral macular drusen. Ophthalmology 1984;91:271–7.
Bressler SB, Maguire MG, Bressler NM, Fine SL . Relationship of drusen and abnormalities of the retinal pigment epithelium to the prognosis of neovascular macular degeneration. The Macular Photocoagulation Study Group. Arch Ophthalmol 1990;108:1442–7.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sparrow, J., Dickinson, A., Duke, A. et al. Seven year follow-up of age-related maculopathy in an elderly British population. Eye 11, 315–324 (1997). https://doi.org/10.1038/eye.1997.67
Issue Date:
DOI: https://doi.org/10.1038/eye.1997.67
Keywords
This article is cited by
-
Remote Monitoring of Visual Function in Patients with Maculopathy: The Aphelion Study
Ophthalmology and Therapy (2024)
-
Drusen prevalence and pigmentary changes in Caucasians aged 18–54 years
Eye (2012)
-
The prevalence and analysis of risk factors for age-related macular degeneration: 18-year follow-up data from the Speedwell eye study, United Kingdom
Eye (2011)
-
Characteristics of progression of early Age-related macular degeneration: the Cardiovascular Health and Age-related maculopathy Study
Eye (2007)
-
Prevalence of age-related maculopathy at two points in time in an elderly British population
Eye (1997)