Risk of age-related macular degeneration in eyes with macular drusen or hyperpigmentation: the Blue Mountains Eye Study cohort.
OBJECTIVE
To quantify the 5-year risk of age-related macular degeneration (AMD) in eyes with different macular drusen characteristics (ie, size, type, location, and total area) or hyperpigmentation in a population-based cohort.


METHODS
The Blue Mountains Eye Study examined 3654 residents during 1992-1994; 2335 (75.1% of survivors) were reexamined during 1997-1999. Retinal photographs were graded using the Wisconsin Age-Related Maculopathy Grading System. Incident AMD lesions were defined by development of neovascular AMD or geographic atrophy in eyes without these lesions at baseline (eyes at risk). Age-adjusted relative risks (RRs) were determined. Generalized estimating equation models were used to estimate odds ratios, adjusting for the correlation between eyes and other AMD risk factors. Main Outcome Measure Incidence of AMD.


RESULTS
Of the 4634 eyes at risk, 52 (1.1%) developed neovascular or atrophic AMD lesions over 5 years. In right eyes, presence vs absence of the following macular signs predicted AMD: drusen that were 125 micro m or larger (13.9 vs 0.6%; age-adjusted RR, 5.7; 95% confidence interval [CI], 3.6-9.0), indistinct soft or reticular drusen (23.2% vs 0.4%; RR, 9.9; 95% CI, 6.4-15.4), total drusen area of half the disc area or more (31.4% vs 0.6%; RR, 13.5; 95% CI, 8.0-22.8), and hyperpigmentation (14.4% vs 0.5%; RR, 8.0; 95% CI, 5.4-11.9). After adjusting for age, sex, and smoking status, eyes with these signs at baseline had a high likelihood of developing AMD. Eyes with Age-Related Eye Disease Study categories 3 and 4 were 5 times more likely to develop AMD compared with eyes in categories 1 and 2.


CONCLUSIONS
This study quantifies the 5-year risk of AMD in eyes with macular drusen and hyperpigmentation.
Department of Ophthalmology, the Centre for Vision Research, and the Save Sight and Westmead Millennium Institutes, University of Sydney, Australia.
Jie Jin
JJ
Wang
Suriya
S
Foran
Wayne
W
Smith
Paul
P
Mitchell
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D016013:Likelihood Functions; D008268:Macular Degeneration / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D015593:Retinal Drusen / Q000150:complications / Q000453:epidemiology*; D012174:Retinitis Pigmentosa / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors