title: Four-year incidence and progression of age-related macular degeneration: the Los Angeles Latino Eye Study.
abstract: 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.
authors.affiliation: Doheny Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA. rvarma@usc.edu
authors.forename: Rohit
authors.initials: R
authors.lastname: Varma
authors.forename: Athena W P
authors.initials: AW
authors.lastname: Foong
authors.forename: Mei-Ying
authors.initials: MY
authors.lastname: Lai
authors.forename: Farzana
authors.initials: F
authors.lastname: Choudhury
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.forename: Stanley P
authors.initials: SP
authors.lastname: Azen
mesh_terms: 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
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