Ten-Year Incidence and Progression of Age-Related Maculopathy

Wang, Jie Jin; Rochtchina, Elena; Lee, Anne J.; Chia, E.; Smith, Wayne; Cumming, Robert G.; Mitchell, Paul

doi:10.1016/j.ophtha.2006.07.017

Cited by 274 publications

(204 citation statements)

References 46 publications

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“…1,2 The Australian incidence of ARMD is consistent with that reported internationally 3,4 and has the congruent nomenclature of ARMD, broadly divided into either geographic ARMD, 'dry' or neovascular ARMD, also known as 'wet' ARMD. In the past, geographic ARMD was considered largely untreatable, 5,6 while neovascular ARMD treatment had demonstrated very limited success.…”

Section: Introductionsupporting

confidence: 63%

Understanding the patient’s lived experience of neovascular age-related macular degeneration: a qualitative study

McCloud

Lake

2015

Eye

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Purpose In industrialised populations agerelated macular degeneration (ARMD) is the leading cause of visual disability of the elderly. Successful new treatment with anti-endothelial growth factors for neovascular-classified ARMD has led to a divergence in treatment and experiences of people ARMD. This study aimed to understand the participant's experience of neovascular ARMD, including ongoing treatment with anti-vascular endothelial growth factor. Methods Twenty-five participants from one clinical site were qualitatively interviewed to elicit their experiences of treatment for neovascular ARMD. Results Two major themes were identified. A life negotiated by neovascular ARMD captures the participants' experience of living with the condition and treatment regime for neovascular ARMD. The second major theme: Uncertainty displayed their appraisal of life, treatment and their perceived future. Conclusions Anxieties concerning the injections, new limitations to lifestyles, and an uncertain future all emerged from the data analysis. However, thankfulness for the treatment, the importance of familiar patterns in treatments and recovery and a guarded optimism also emerged. Knowledge of the experiences, anxieties and concerns of this patient population can be used to inform clinical practice and lead to patient-centred care.

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Section: Introductionsupporting

confidence: 63%

Understanding the patient’s lived experience of neovascular age-related macular degeneration: a qualitative study

McCloud

Lake

2015

Eye

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“…22,24,31 Graders were masked to participants' CKD status, and the intergrader and intragrader reliability showed good agreement in identifying individual lesions.…”

Section: Assessment Of Amdmentioning

confidence: 99%

“…22,24,31 Incident early AMD was defined as the absence of late AMD and presence of either: 1) large (Ͼ125-m diameter) indistinct soft or reticular drusen or 2) both large distinct soft drusen and retinal pigmentary abnormalities (hyperpigmentation or hypopigmentation) at the 3rd examination in either eye of persons free of early AMD in both eyes at the 2nd examination. 31 Similarly, incident late AMD was defined as the appearance of neovascular AMD or geographic atrophy at the 3rd examination in either eye of persons without AMD lesions in both eyes at the 2nd examination.…”

Section: Assessment Of Amdmentioning

confidence: 99%

CKD Increases the Risk of Age-Related Macular Degeneration

Liew

Mitchell

Wong³

et al. 2008

Journal of the American Society of Nephrology

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Age-related macular degeneration is the leading cause of irreversible blindness in the United States and often coexists with chronic kidney disease. Both conditions share common genetic and environmental risk factors. A total of 1183 participants aged 54ϩ were examined in the population-based, prospective cohort Blue Mountains Eye Study (Australia) to determine if chronic kidney disease increases the risk of age-related macular degeneration. Moderate chronic kidney disease (estimated glomerular filtration rate Ͻ 60 ml/min per 1.73 m 2 based on the Cockcroft-Gault equation) was present in 24% of the population (286 of 1183). The 5-yr incidence of early age-related macular degeneration was 3.9% in participants with no/mild chronic kidney disease (35 of 897) and 17.5% in those with moderate chronic kidney disease (50 of 286). After adjusting for age, sex, cigarette smoking, hypertension, complement factor H polymorphism, and other risk factors, persons with moderate chronic kidney disease were 3 times more likely to develop early age-related macular degeneration than persons with no/mild chronic kidney disease (odds ratio ϭ 3.2; 95% confidence interval, 1.8 to 5.7, P Ͻ 0.0001). Each SD (14.8 ml/min per 1.73 m 2 ) decrease in Cockcroft-Gault estimated glomerular filtration rate was associated with a doubling of the adjusted risk for early age-related macular degeneration (odds ratio ϭ 2.0; 95% confidence interval, 1.5 to 2.8, P Ͻ 0.0001). In conclusion, persons with chronic kidney disease have a higher risk of early age-related macular degeneration, suggesting the possibility of shared pathophysiologic mechanisms between the two conditions. 19: 806 -811, 200819: 806 -811, . doi: 10.1681 Chronic kidney disease (CKD) is a relatively common condition whose prevalence rises rapidly with age. CKD is estimated to affect over 50% of older persons in the United States 1 and has important extrarenal systemic consequences, such as cardiovascular, metabolic, and hematologic abnormalities. However, the effects of CKD on the sensory organs, such as the eye, are not well understood. J Am Soc NephrolAge-related macular degeneration (AMD) is another relatively common condition in older persons and is the leading cause of blindness and low vision in the United States. 2 CKD and AMD may share common risk factors and pathophysiologic mechanisms. 3 For example, vascular risk factors, such as hypertension and cigarette smoking, may increase risk of both conditions. 4 -7 CKD is known to accelerate the progression of atherosclerosis and increase propensity to oxidative stress, 6 both of which are implicated in AMD pathogenesis. 8,9 Systemic in-

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“…Several studies have shown a greater risk of developing future AMD given the presence of these milder abnormalities. 29,[42][43][44] Considering the increase in life expectancy due to age-specific reductions in cardiovascular mortality, more men will survive to develop AMD in the future with inevitable health consequences.…”

Section: Discussionmentioning

confidence: 99%

The prevalence and analysis of risk factors for age-related macular degeneration: 18-year follow-up data from the Speedwell eye study, United Kingdom

Ngai

Stocks

Sparrow

et al. 2011

Eye

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Aims/Purpose To determine the prevalence of age-related maculopathy (ARM) and age-related macular degeneration (AMD) in men aged 65-83 years living in the Speedwell region of Bristol, United Kingdom and identify modifiable risk factors. Methods A total of 2348 men recruited to the Speedwell prospective cohort study in 1979 were followed up in 1997 with an eye questionnaire and had retinal photographs that were assessed using the International Classification System for ARM. Results In all, 934 men (66.8% response rate) attended with a mean of 17.9 years (15.3-20.6 years) follow-up. Early ARM (grades 2-3) was found in 9.2% (95% confidence interval (CI) 7.4%, 11.4%) and late age-related maculopathy (grade 4, AMD) in 0.5% (95% CI 0.2%, 1.2%). The risk of ARM (grades 2-4) was increased with raised C-reactive protein and consumption of lard and solid fats, whereas triglyceride levels were associated with a lower risk. The latter were confirmed in multivariable analyses and in addition, haemodynamic measures also predicted risk (eg mean arterial pressure odds ratio (OR) per z-score 1.37, 95% CI 1.04, 1.79). Conclusions In a representative cohort of men aged 65-83 from Bristol, United Kingdom, many had macular changes that put them at higher risk of developing AMD. Various modifiable exposures were associated with an increased risk ARM/AMD. Opportunities for screening and undertaking secondary prevention interventions need to be explored to prevent progression of the disease and blindness.

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Ten-Year Incidence and Progression of Age-Related Maculopathy

Cited by 274 publications

References 46 publications

Understanding the patient’s lived experience of neovascular age-related macular degeneration: a qualitative study

Understanding the patient’s lived experience of neovascular age-related macular degeneration: a qualitative study

CKD Increases the Risk of Age-Related Macular Degeneration

The prevalence and analysis of risk factors for age-related macular degeneration: 18-year follow-up data from the Speedwell eye study, United Kingdom

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