14-year incidence, progression, and visual morbidity of age-related maculopathy: the Copenhagen City Eye Study.
OBJECTIVE
To describe the 14-year incidence of age-related maculopathy (ARM) lesions and the related visual loss.


METHODS
Population-based cohort study.


METHODS
Nine hundred forty-six residents (age range, 60-80 years) of Copenhagen participated in the study from 1986 through 1988. Excluding participants who had died since baseline, 359 persons (97.3% of survivors) were reexamined from 2000 through 2002.


METHODS
Participants underwent extensive ophthalmologic examinations. Age-related maculopathy lesions were determined by grading color fundus photographs from the examinations using a modified Wisconsin Age-Related Maculopathy Grading System.


METHODS
Incidence of drusen type and size, pigmentary abnormalities, pure geographic atrophy, exudative ARM, visual impairment, and blindness.


RESULTS
The 14-year incidences of early and late ARM were 31.5% and 14.8%, respectively. Individuals 75 to 80 years of age at baseline had significantly (P< or =0.05) higher 14-year incidences of the following lesions than those aged 60 to 64 years: medium or large drusen (> or =125 microm; 34.2% vs. 12.8%, respectively), soft drusen (45.2% vs. 21.4%), pigmentary abnormalities (31.4% vs. 17.0%), pure geographic atrophy (17.4% vs. 1.0%), and exudative ARM (23.3% vs. 5.7%). Severe drusen type, large drusen, and retinal pigmentary abnormalities at baseline were important predictors of incident late ARM. The 14-year incidences of visual impairment (<20/40 but >20/200) or legal blindness from late ARM were 6.0% and 3.4%, respectively. Late ARM caused 35.7% of all visual impairment and 66.7% of all blindness.


CONCLUSIONS
There is a high incidence of ARM lesions in this elderly white population. Severe drusen type and size or a combination of drusen and pigmentary abnormalities significantly increases the risk of developing late ARM, the most frequent cause of legal blindness in this population.
Buch
Helena
H
Department of Ophthalmology, National University Hospital (Rigshospitalet), Copenhagen, Denmark. hbh@dadlnet.dk
Nielsen
Niels V
NV
Vinding
Troels
T
Jensen
Gorm B
GB
Prause
Jan U
JU
la Cour
Morten
M
D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008268:Macular Degeneration / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015593:Retinal Drusen / Q000453:epidemiology / Q000503:physiopathology; D012174:Retinitis Pigmentosa / Q000453:epidemiology / Q000503:physiopathology; D012307:Risk Factors; D014786:Vision Disorders / Q000453:epidemiology* / Q000503:physiopathology; D014792:Visual Acuity; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*