title: Age-related maculopathy and sunlight exposure evaluated by objective measurement.
abstract: OBJECTIVE
  To study the relationship between age-related maculopathy (ARM) and exposure to sunlight using an objective method.
  
  
  METHODS
  In a case-control study of Japanese men aged > or = 50 years (67 controls without ophthalmic disease and 148 with ARM), those with ARM were separated into groups of early (n = 75) and late (n = 73) ARM. Facial wrinkle length and area of hyperpigmentation, which are considered to be associated with exposure to sun, were measured using imaging with computer-based image analysis. Skin tone was also measured on the upper inner arm, which is not exposed to sun. Early and late ARM association with skin measurements was then evaluated.
  
  
  RESULTS
  Significantly more facial wrinkling (p = 0.047, odds ratio 3.8; 95% CI 1.01 to 13.97) and less facial hyperpigmentation (p = 0.035, odds ratio 0.3; 95% CI 0.08 to 0.92) was present in late ARM cases. The relationship between skin tone and ARM risk was not statistically significant.
  
  
  CONCLUSIONS
  This objective method showed that lifetime exposure to sunlight is an important factor in the progression of late ARM. An individual's reaction to sunlight exposure may have a role in ARM progression in addition to total lifetime exposure to sunlight.
authors.affiliation: Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hirakawa
authors.forename: M
authors.initials: M
authors.lastname: Tanaka
authors.forename: Y
authors.initials: Y
authors.lastname: Tanaka
authors.forename: A
authors.initials: A
authors.lastname: Okubo
authors.forename: C
authors.initials: C
authors.lastname: Koriyama
authors.forename: M
authors.initials: M
authors.lastname: Tsuji
authors.forename: S
authors.initials: S
authors.lastname: Akiba
authors.forename: K
authors.initials: K
authors.lastname: Miyamoto
authors.forename: G
authors.initials: G
authors.lastname: Hillebrand
authors.forename: T
authors.initials: T
authors.lastname: Yamashita
authors.forename: T
authors.initials: T
authors.lastname: Sakamoto
mesh_terms: D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D005145:Face; D005654:Fundus Oculi; D006801:Humans; D017495:Hyperpigmentation / Q000209:etiology; D016013:Likelihood Functions; D008268:Macular Degeneration / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015595:Skin Aging / Q000528:radiation effects*; D012880:Skin Pigmentation / Q000528:radiation effects*; D012907:Smoking / Q000009:adverse effects; D013472:Sunlight / Q000009:adverse effects*