Four-year incidence and progression of age-related macular degeneration: the Los Angeles Latino Eye Study.
OBJECTIVE
To estimate 4-year incidence and progression of early and advanced age-related macular degeneration (AMD).


METHODS
Population-based cohort study.


METHODS
A comprehensive ophthalmologic examination including stereoscopic fundus photography was performed on adult Latinos at baseline and follow-up. Photographs were graded using a modified Wisconsin Age-Related Maculopathy Grading System. For estimations of incidence and progression of AMD, the Age Related Eye Disease Study Scale was used. Main outcome measures are incidence and progression of early AMD (drusen type, drusen size, and retinal pigmentary abnormalities) and advanced AMD (exudative AMD and geographic atrophy).


RESULTS
A total of 4658 of 6100 subjects (76%) completed the follow-up examination. The 4-year incidence of early AMD was 7.5% (95% CI: 6.7, 8.4) and advanced AMD was 0.2% (95% CI: 0.1, 0.4). Progression of any AMD occurred in 9.2% (95% CI: 8.3, 10.1) of at-risk participants. Incidence and progression increased with age. Incidence of early AMD in the second eye (11.2%) was higher than incidence in the first eye (6.9%). Baseline presence of soft indistinct large drusen >or=250 microm in diameter was more likely to predict the 4-year incidence of pigmentary abnormalities, geographic atrophy, and exudative AMD than smaller or hard or soft distinct drusen.


CONCLUSIONS
Age-specific incidence and progression of AMD in Latinos are lower than in non-Hispanic whites. While incident early AMD is more often unilateral, the risk of its development in the second is higher than in the first eye. Older people and those with soft indistinct large drusen had a higher risk of developing advanced AMD compared to those who were younger and did not have soft indistinct large drusen.
Varma
Rohit
R
Doheny Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA. rvarma@usc.edu
Foong
Athena W P
AW
Lai
Mei-Ying
MY
Choudhury
Farzana
F
Klein
Ronald
R
Azen
Stanley P
SP
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D015994:Incidence; D015141:Los Angeles / Q000453:epidemiology; D008268:Macular Degeneration / Q000145:classification / Q000175:diagnosis / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D010781:Photography; D011795:Surveys and Questionnaires
Invest Ophthalmol Vis Sci. 2001 Sep;42(10):2237-41
11527936
Ophthalmology. 2005 May;112(5):787-98
15878058
Ophthalmology. 1995 Oct;102(10):1450-60
9097791
Ophthalmology. 2002 Jun;109(6):1092-7
12045049
Arch Ophthalmol. 2005 Nov;123(11):1570-4
16286620
Arch Ophthalmol. 2005 Nov;123(11):1484-98
16286610
Arch Ophthalmol. 2003 Apr;121(4):519-26
12695249
Ophthalmology. 2004 Jun;111(6):1176-82
15177968
Ophthalmology. 1997 Jan;104(1):7-21
9022098
Am J Ophthalmol. 2007 Jun;143(6):1013-23
17399676
Acta Ophthalmol Scand. 2005 Jun;83(3):333-6
15948787
Ophthalmology. 1992 Jun;99(6):933-43
1630784
Ophthalmology. 2004 Apr;111(4):706-11
15051202
Ophthalmology. 1991 Jul;98(7):1128-34
1843453
Ophthalmology. 2004 Jul;111(7):1288-97
15234128
Arch Ophthalmol. 1995 Jun;113(6):728-35
7786213
Ophthalmology. 2006 Oct;113(10):1846-53
16889831
Ophthalmology. 2007 Jan;114(1):99-103
17198853
BMC Genet. 2009 Nov 10;10:71
19903357
Ophthalmology. 2005 Jan;112(1):152-8
15629836
Ophthalmology. 2004 Jun;111(6):1121-31
15177962
Am J Ophthalmol. 2000 Nov;130(5):658-63
11078846
Ophthalmology. 2008 Jan;115(1):116-26
17675159