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ABSTRACT.Purpose: To examine the association between potential risk factors and the 14-year incidence of age-related maculopathy (ARM). Design: Population-based cohort study. Participants: At baseline, 946 volunteers participated in the study during 1986-88. These subjects were between 60 and 80 years of age and lived in the Østerbro district of Copenhagen. Excluding participants who had died since baseline, 359 subjects (97.3% of survivors) were re-examined 14 years later, during [2000][2001][2002]. A total of 31.8% (301/946) of the original material was included in the risk factor analyses. Methods: Participants underwent an ophthalmological examination at Rigshospitalet, the National University Hospital of Copenhagen. Similar standardized protocols for physical examination were used at the baseline and follow-up examinations. Age-related maculopathy lesions were determined by the same grader grading colour fundus photographs from both examinations using a modification of the Wisconsin Age-related Maculopathy Grading System protocol. Results: Of the 359 participants, 94 had incident early ARM and 52 had incident late ARM at follow-up in either eye. In logistic regression, the risk factors for early ARM or worse were as follows: cataract (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.2-6.2); family history of ARM (OR 4.5, 95% CI 1.3-15.5), and alcohol consumption > 250 g/week (OR 4.6, 95% CI 1.1-19.2). High levels of apolipoprotein B (> 100 mg/l) decreased the risk of development of early ARM or worse (OR 0.4, 95% CI 0.2-0.8), while high levels of apolipoprotein A1 ( ‡ 150 mg/l) increased the risk of late ARM (OR 2.5, 95% CI 1.2-5.3). Advanced age at baseline was also associated with the incidence of late ARM (OR 2.0, 95% CI 1.4-2.9). Conclusions: These findings indicate a direct correlation between age, cataract, family history, alcohol consumption, the apolipoproteins A1 and B and the 14-year incidence of ARM.

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ABSTRACT.Purpose: To study the prevalence and causes of bilateral and unilateral blindness in an elderly urban Danish population. Methods: Data originated from a Danish epidemiologic cross-sectional random sample population eye survey conducted during the years 1986-1988. The population consisted of 1,000 inhabitants aged 60 to 80 years in Copenhagen. The participants underwent an extensive ophthalmologic examination. A participation rate of 96.9% was achieved. Any blindness was defined as best-corrected visual acuity (VA) worse than 0.05 (the WHO criteria) and VA of 0.1 or worse (the National criteria (NC) of blindness). Results: The prevalence rates of bilateral and unilateral blindness were, respectively, 0.53% and 3.38% according to WHO, but 1.06% and 4.44% using NC. Bilateral blindness rose significantly with age (pΩ0.02). According to NC, agerelated macular degeneration (AMD) was the leading cause of bilateral blindness, accounting for 60% of all blind persons. Glaucoma, myopic macular degeneration, cataract and retinitis pigmentosa were jointly the second most common cause, each accounting for 10% of all bilaterally blind persons. Diabetic retinopathy was not a cause of bilateral blindness. Amblyopia was the most frequent, AMD the second most frequent, and diabetic retinopathy was among the third most common cause of unilateral blindness accounting for, respectively, 28.60%, 16.66% and 9.52% of all unilateral blindness. Conclusions: Blindness was associated with increasing age. A calculation indicates that among Danes aged 60 to 80 years 7,736 are bilaterally blind and 35,503 suffer from unilateral blindness. This study highlights AMD as the most important cause.Key words (MeSH Terms): bilateral blindness -unilateral blindness -cause of blindness -epidemiology -prevalence -urban population.

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