Prevalence of age-related macular degeneration in an elderly UK Caucasian population—The Bridlington Eye Assessment Project: a cross-sectional study

Abstract

ImportanceThere is paucity of data on prevalence and disease asymmetry of age-related macular degeneration (AMD), particularly the earlier stages, in the UK population.Objective and PurposeTo determine the prevalence of age-related macular degeneration in an elderly Caucasian UK population.DesignCross-sectional population study, 2002-2006.ParticipantsResidents in the study area of Bridlington aged 65 years and older.MethodsFull-ophthalmic examination was undertaken in 3549 participants, of eligible 6319 Caucasian population (response rate of 56%). Non-stereoscopic Colour fundus photographs (30°) were graded masked using a modified Rotterdam Classification for 3475 (98%) participants with gradable images. Prevalence for different AMD grades were calculated. Demographic details were analysed then integrated with the AMD gradings for full analysis. Prevalence rates for the different AMD Grades were calculated, as well as the age-specific prevalences.ResultsAMD prevalence in the worst eye were 38.5% grade 0, 41.4% grade 1, 12.8% grade 2, 2.8% grade 3, and 4.6% grade 4. Geographic atrophy (grade 4a) occurred in 2.5%, and neovascular AMD (grade 4b) in 1.8%. Prevalence increased with age such that grade 4 (advanced) AMD was 2.2% in the 65-69 years group, 15.8% for the 85-90, and 21.2% for over 90 years. There was significant asymmetry between the two eyes of individuals with advanced AMD (P<0.001), such that vision loss was unilateral. Persons with more advanced AMD grades were more likely to be dissatisfied with their vision.ConclusionsAdvanced AMD occurs more commonly in the UK Caucasian population than previously reported. Significant asymmetry between the two eyes occurs in individuals with unilateral advanced AMD so that visual impairment statistics do not represent true prevalence of advanced AMD. Persons with more advanced AMD were more likely to be dissatisfied with their vision.

Prevalence of peripapillary choroidal neovascular membranes (PPCNV) in an elderly UK population—the Bridlington eye assessment project (BEAP): a cross-sectional study (2002–2006)

“…Previous reports on the prevalence and associations of PPCNV are based on case reports or small case series from hospital data. To the best of our knowledge, there are no reports on population prevalence of PPCNV except for our previous report of worse eye prevalence of 0.29% for Grade 4c (PPCNV), compared to 1.8% for neovascular AMD (nAMD) (grade 4b AMD) and 2.5% for geographic atrophy (GA) (grade 4a AMD) [12]. Furthermore, there are no data available in the literature on the population prevalence of asymptomatic PPCNV.…”

“…The BEAP study methods, including image acquisition and analysis, have been reported previously [12]. In summary, the BEAP is a single centre population-based prevalence study, with the primary objective to investigate the utility of screening for eye disease in an elderly population ≥65 years, using clinical examination by trained optometrists and digital imaging technology.…”

“…The diagnosis of PPCNV was clinical, and based on surrogate clinical features of CNV (as previously described) [12] directly adjacent to and contiguous with the optic disc. These include definite RPE detachment, haemorrhagic or serous, and/or subretinal or sub-RPE haemorrhages unassociated with any other vascular lesion and/or intraretinal, subretinal or sub-RPE glial tissue, and/or subretinal or sub-RPE neovascular membrane as characterized by grey/yellowish discoloration.…”

“…Signs of age-related maculopathy (ARM) within an ETDRS macular grid were recorded using a modified Rotterdam grade as previously described [12]. Retinal pigment epithelial (RPE) changes and presence of drusen in the Fig.…”

Natural course of adult-onset vitelliform lesions in eyes with and without comorbid subretinal drusenoid deposits

“…No genetic testing was performed on the population, and no electrooculograms were undertaken. Eyes with drusen were not excluded (given their high prevalence within this age group) [8], unless they were the dominant clinical feature with suspicion of a central drusenoid pigment epithelial detachment. No family history data were recorded for the majority of patients.…”