No abstract

The authors examined associations between smoking and alcohol consumption and the long-term incidence of age-related maculopathy (ARM) in people in the Beaver Dam Eye Study who were aged 43-86 years (n = 3,684) in 1988-1990 and examined over a 10-year period. ARM status was determined by grading stereoscopic color fundus photographs. After controlling for age, sex, and other factors, the authors found that people who had smoked more were more likely to develop large (> or =250 micro m in diameter) soft drusen (risk ratio (RR) per 10 pack-years smoked = 1.08, 95% confidence interval (CI): 1.02, 1.14) and pigmentary abnormalities (RR = 1.09, 95% CI: 1.04, 1.14) and to have progression of early ARM (RR = 1.05, 95% CI: 1.00, 1.10) than people who had smoked less. Smoking was not associated with the incidence of late ARM. People who reported being heavy drinkers at baseline were more likely to develop late ARM (RR = 6.94, 95% CI: 1.85, 26.1) than people who reported never having been heavy drinkers. Smoking appears to have a modest, positive association with early but not late signs of ARM, and heavy drinking appears to be related to an increased risk of late ARM, although the exposure and outcome were infrequent, and the effect is based on few exposed cases.

Multivariate proportional hazards regression was used to compare outcome by donor type and identify other prognostic factors. Most transplant recipients were younger than 5 years (79%), had a pretransplantation performance score greater than or equal to 90% (63%), received pretransplantation preparative regimens without radiation (82%), and had non-Tcell-depleted grafts (77%). Eighty percent received their transplant after 1986. The 5-year probability of survival (95% confidence interval) for all subjects was 70% (63%-77%). Probabilities differed by donor type: 87% (74%-93%) with HLAidentical sibling donors, 52% (37%-65%) with other related donors, and 71% (58%-80%) with unrelated donors (P ‫؍‬ .0006).

These findings indicate relationships between higher pulse pressure (a presumed indicator of age-related elastin and collagen changes in Bruch's membrane) and systolic blood pressure with an increased 10-year incidence of some lesions defining early age-related maculopathy and exudative macular degeneration.

To examine the association of sunlight exposure and indicators of sun sensitivity with the 10year incidence of age-related maculopathy (ARM).