title: Age-related macular disease in rural southern Italy.
abstract: OBJECTIVE
  To report the prevalence of age-related maculopathy (ARM) in Salandra, a small, isolated southern Italian community, to test the hypothesis that an environmental factor, scarce in such a remote community but ubiquitous in modern industrial societies, might modify the risk of developing ARM.
  
  
  METHODS
  Population-based cross-sectional survey.
  
  
  METHODS
  Prevalence of advanced age-related macular degeneration (ARMD) (geographic atrophy or exudative maculopathy) and ARM (large, soft drusen or retinal pigment epithelium changes, or both) defined by fundus biomicroscopy and 30 degrees stereoscopic, macular photography. Self-sustenance was assessed by interview of participants and local shop retailers. The degree of genetic isolation was computed using a model that fits the genetic population structure with the frequency distribution of surnames in the community.
  
  
  RESULTS
  A full ophthalmic examination was undertaken in 366 (63.5%) of 576 eligible participants, 354 (96.7%) of whom had clinical or photographic assessment for the presence of ARMD and 310 (84.6%) of whom had drusen characteristics graded on color transparencies for ARM. The overall prevalence of ARMD was 1.1%. Drusen larger than 50 microns and more numerous than 10 were found in 4.5% of subjects. Salandra was the birthplace of 87.2% of participants and for 77.3% of both parents of each subject. People in the community tended to consume homegrown products.
  
  
  CONCLUSIONS
  The prevalence of ARM may be lower in this self-sustained farming community than elsewhere in the industrialized world.
authors.affiliation: Queen's Medical Center, University Hospital Nottingham, England.
authors.forename: S
authors.initials: S
authors.lastname: Pagliarini
authors.forename: A
authors.initials: A
authors.lastname: Moramarco
authors.forename: R P
authors.initials: RP
authors.lastname: Wormald
authors.forename: B
authors.initials: B
authors.lastname: Piguet
authors.forename: C
authors.initials: C
authors.lastname: Carresi
authors.forename: C
authors.initials: C
authors.lastname: Balacco-Gabrieli
authors.forename: K S
authors.initials: KS
authors.lastname: Sehmi
authors.forename: A C
authors.initials: AC
authors.lastname: Bird
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008268:Macular Degeneration / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010781:Photography; D010865:Pilot Projects; D015995:Prevalence; D015593:Retinal Drusen / Q000473:pathology; D012424:Rural Population