title: Five-year incidence of age-related maculopathy lesions: the Blue Mountains Eye Study.
abstract: OBJECTIVE
  To describe the 5-year incidence and progression of early and late age-related maculopathy (ARM) lesions.
  
  
  METHODS
  Population-based cohort study.
  
  
  METHODS
  Three thousand six hundred fifty-four noninstitutionalized residents, aged 49 years or older, living in the Blue Mountains area west of Sydney, Australia, participated in the study during 1992 to 1994. The cohort was reexamined after 5 years (1997-1999). Excluding 543 participants who died since the baseline, 2335 (75%) survivors attended 5-year follow-up examinations.
  
  
  METHODS
  Retinal photographs from both examinations were graded using the Wisconsin ARM Grading System. Photographs of participants with any ARM lesions at either examination were regraded in detail using a modification of the side-by-side method developed for the Beaver Dam Eye Study.
  
  
  METHODS
  Incidence and progression of ARM lesions were defined in a similar manner to that used in the Beaver Dam Eye Study.
  
  
  RESULTS
  Incidence rates for all ARM lesions increased significantly with age. For late ARM lesions (geographic atrophy and neovascular ARM), the overall 5-year incidence was 1.1%. The combined late ARM incidence was 0.0%, 0.6%, 2.4%, and 5.4% for participants aged 60 years and younger, 60 to 69 years, 70 to 79 years, and 80 years and older at baseline, respectively. After excluding participants with either early or late ARM in either eye at baseline, the overall 5-year incidence of early ARM was 8.7%, including 3.2%, 7.4%, 18.3%, and 14.8% for the corresponding age groups. The incidence of neovascular ARM in women was double that for men (P = 0.1).
  
  
  CONCLUSIONS
  This study has documented the incidence of ARM lesions in an older Australian population. The slightly higher incidence of hyperpigmentation found in our population compared with the Beaver Dam Eye Study may be due to sample variability, or this could reflect real differences between the two populations. Our lower incidence of soft drusen could have resulted from our non-inclusion of intermediate soft drusen in the soft distinct and indistinct drusen categories.
authors.affiliation: Department of Ophthalmology and the Save Sight and Westmead Millennium Institutes, the University of Sydney, Westmead, nsw, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.forename: Jie Jin
authors.initials: JJ
authors.lastname: Wang
authors.forename: Suriya
authors.initials: S
authors.lastname: Foran
authors.forename: Wayne
authors.initials: W
authors.lastname: Smith
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D008268:Macular Degeneration / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D010781:Photography; D017678:Sex Distribution