The epidemiology of age-related macular degeneration.
OBJECTIVE
To review the epidemiology of age-related macular degeneration (AMD).


METHODS
Evidence from epidemiologic data regarding the natural history of AMD and its risk factors are presented.


RESULTS
Large, soft drusen associated with pigmentary abnormalities increase the risk of progression to advanced AMD. Large soft drusen may fade over time. Advanced AMD is more likely to be present in whites than blacks, despite the similar prevalence of soft drusen in both groups. Neovascular AMD is more frequent than geographic atrophy in most population-based studies in whites in America, Australia, and the Netherlands than in similar population-based studies in Iceland and Norway. After age and family history, there are few consistent relationships of risk factors to AMD. Of these, the relationship of smoking, hypertension, and cataract surgery to advanced AMD have been most consistent.


CONCLUSIONS
Long-term epidemiologic studies have provided information on the distribution and the natural history of AMD and its associated risk factors. It is not known what effect reduction of blood pressure and the cessation of smoking might have on the incidence and progression of AMD.
Klein
Ronald
R
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, Wisconsin 53726, USA. kleinr@epi.ophth.wisc.edu
Peto
Tunde
T
Bird
Alan
A
Vannewkirk
Mylan R
MR
D018450:Disease Progression; D014943:Global Health; D006801:Humans; D015994:Incidence; D008268:Macular Degeneration / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology