title: HISTORY OF SUNLIGHT EXPOSURE IS A RISK FACTOR FOR AGE-RELATED MACULAR DEGENERATION.
abstract: OBJECTIVE
  To evaluate effects of current and past sunlight exposure and iris color on early and late age-related macular degeneration (AMD).
  
  
  METHODS
  Of 3,701 individuals from the EUGENDA database, 752 (20.3%) showed early AMD, 1,179 (31.9%) late AMD, and 1,770 (47.8%) were controls. Information about current and past sunlight exposure, former occupation type, subdivided in indoor working and outdoor working, and iris color were obtained by standardized interviewer-assisted questionnaires. Associations between environmental factors adjusted for age, gender, and smoking and early and late AMD were performed by multivariate regression analysis.
  
  
  RESULTS
  Current sunlight exposure showed no association with early AMD or late AMD, but past sunlight exposure (≥8 hours outside daily) was significantly associated with early AMD (odds ratio: 5.54, 95% confidence interval 1.25-24.58, P = 0.02) and late AMD (odds ratio: 2.77, 95% confidence interval 1.25-6.16, P = 0.01). Outside working was found to be associated with late AMD (odds ratio: 2.57, 95% confidence interval 1.89-3.48, P = 1.58 × 10). No association was observed between iris color and early or late AMD.
  
  
  CONCLUSIONS
  Sunlight exposure during working life is an important risk factor for AMD, whereas sunlight exposure after retirement seems to have less influence on the disease development. Therefore, preventive measures, for example, wearing sunglasses to minimize sunlight exposure, should start early to prevent development of AMD later in life.
authors.affiliation: *Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany; and †Department of Ophthalmology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
authors.forename: Tina
authors.initials: T
authors.lastname: Schick
authors.forename: Lebriz
authors.initials: L
authors.lastname: Ersoy
authors.forename: Yara T E
authors.initials: YT
authors.lastname: Lechanteur
authors.forename: Nicole T M
authors.initials: NT
authors.lastname: Saksens
authors.forename: Carel B
authors.initials: CB
authors.lastname: Hoyng
authors.forename: Anneke I
authors.initials: AI
authors.lastname: den Hollander
authors.forename: Bernd
authors.initials: B
authors.lastname: Kirchhof
authors.forename: Sascha
authors.initials: S
authors.lastname: Fauser
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D016208:Databases, Factual; D004781:Environmental Exposure / Q000009:adverse effects*; D005127:Eye Color; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000145:classification / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009790:Occupations; D016017:Odds Ratio; D011832:Radiation Injuries / Q000145:classification / Q000175:diagnosis / Q000209:etiology*; D012160:Retina / Q000528:radiation effects*; D012307:Risk Factors; D013472:Sunlight / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D014466:Ultraviolet Rays / Q000009:adverse effects*