title: Prevalence and determinants of age-related macular degeneration in central Sri Lanka: the Kandy Eye Study.
abstract: OBJECTIVE
  To determine the prevalence, associations and risk factors for age-related macular degeneration (ARMD) in central Sri Lanka.
  
  
  METHODS
  The study was a population-based, cross-sectional survey of residents aged > or = 40 years in rural Sri Lanka. ARMD was assessed on dilated fundoscopy using the International Age-Related Maculopathy Epidemiology Study Group classification system.
  
  
  RESULTS
  Of the 1721 subjects identified, 1375 participated (79.9%). Of the participants, 1013 were aged > or = 50 years (73.6%). The prevalence of any ARMD (adjusted for study design) was 4.72 (95% CI 2.22 to 7.20)% with 3.82 (95% CI 1.60 to 6.04)% early ARMD and 1.70 (95% CI 0.14 to 3.27)% late ARMD. Age (p<0.001) and Sinhalese ethnicity (p = 0.016) were significantly associated with ARMD. Men had a tendency toward a higher prevalence of ARMD than women, although this was not statistically significant (p = 0.081). Ocular risk factors such as cortical cataract (p = 0.024) and pseudophakia (p = 0.003) were associated with ARMD on the univariate but not multivariate analyses. Illiteracy and the identification of social supports were significantly associated with ARMD on univariate analyses. However, only social support was statistically significant after multivariate analysis (p = 0.024).
  
  
  CONCLUSIONS
  Although the prevalence of ARMD is slightly lower in Sri Lanka than surrounding regions, it contributes to a higher proportion of visual impairment, including blindness. Risk factors include age and Sinhalese ethnicity.
authors.affiliation: South Australian Institute of Ophthalmology, North Terrace, Adelaide, South Australia, Australia 5000. lgoold@med.usyd.edu.au
authors.forename: L A
authors.initials: LA
authors.lastname: Goold
authors.forename: K
authors.initials: K
authors.lastname: Edussuriya
authors.forename: S
authors.initials: S
authors.lastname: Sennanayake
authors.forename: T
authors.initials: T
authors.lastname: Senaratne
authors.forename: D
authors.initials: D
authors.lastname: Selva
authors.forename: T R
authors.initials: TR
authors.lastname: Sullivan
authors.forename: R J
authors.initials: RJ
authors.lastname: Casson
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D001766:Blindness / Q000453:epidemiology / Q000209:etiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012423:Rural Health / Q000706:statistics & numerical data; D012737:Sex Factors; D013188:Sri Lanka / Q000453:epidemiology; D014786:Vision Disorders / Q000453:epidemiology / Q000209:etiology