Nordic research in ophthalmology

Ophthalmic Education: The Top 100 Cited Articles in Ophthalmology Journals

Purpose  To identify the top 100 (T100) cited articles on ophthalmic education and examine trends and areas of focus in ophthalmic education. Methods  A literature search was conducted for articles published between 2011 and 2021 related to ophthalmic education within ophthalmology journals using the ISI Web of Science Core Collection database. The search was performed in June 2022 and was conducted using the search phrase ([educat* OR teach* OR instruct* OR train* OR "medical student*" OR residen* OR fellow* OR undergrad* OR postgrad* OR "faculty" OR "attending"] AND *ophthalm*). Results were analyzed using VOSviewer v.1.6.18 and statistical analysis was performed using Microsoft Excel. Results  The majority of articles were published in the Journal of Cataract & Refractive Surgery (19%), followed by Ophthalmology (12%), and Eye (12%). Articles were most often published in the year 2013 (15%), followed by 2014 (12%) and 2012 (12%). Articles most commonly originated from English-speaking countries, including the United States (43%), England (14%), Canada (8%), and India (8%). Topics most often examined in ophthalmic education were resident education (51%), medical school education (21%), and surgical training (21%). The most common study types were cohort studies (22%), case series (21%), and prospective trials (16%). There were 16 institutions that produced more than one article in the T100 articles list. Conclusion  The T100 articles on ophthalmic education were primarily U.S. based and focused on resident education, surgical training, and medical school ophthalmic curriculum. Further research into ophthalmic education is warranted to establish evidence-based curricula guidelines.

Prevalence of age-related macular degeneration in a large European cohort: results from the population-based Gutenberg Health Study

BACKGROUND

The aim of this study was to describe the sex- and age-specific prevalence of age-related macular degeneration (AMD) and its correlation with urban or rural residence in a large and relatively young European cohort.

METHODS

We evaluated fundus photographs from participants in the Gutenberg Health Study (GHS), a population-based, prospective, observational, single-centre study in the Rhineland-Palatine region in midwestern Germany. The participants were 35-74 years of age at enrolment. The fundus images were classified as described in the Rotterdam Study and were graded independently by two experienced ophthalmologists (CK and UBK) based on the presence of hard and soft drusen, retinal pigmentary abnormalities, and signs of atrophic or neovascular age-related macular generation (AMD).

RESULTS

Photographs from 4,340 participants were available for grading. Small, hard drusen (<63 μm, stages 0b and 0c) were present in 37.4% of participants (95% confidence interval [CI], stage 0b, 31.6% [30.3-33.7]; stage 0c, 5.8% [5.1-6.5]). Early AMD (soft drusen, pigmentary abnormalities, stages 1-3) was present in 3.8% of individuals in the youngest age group (35-44 years) (95% CI, stage 1a, 0.4% [0.3-0.5%]; stage 1b, 3.2% [2.9-3.5%]; stage 2a, 0.1% [0.1-0.2%]; stage 2b, 0% [0-0.0%]; stage 3, 0.1% [0.1-0.2%]), whereas late AMD (stages 4a and 4b) did not appear in the youngest age group. In all age groups, signs of early AMD were detected in 11.9% of individuals (stage 1a, 2.1% [1.7-2.6]; stage 1b, 8.0% [7.2-8.8]; stage 2a, 1.0% [0.7-1.3]; stage 2b, 0.5% [0.3-0.7]; stage 3, 0.3% [0.2-0.6]). Late AMD (geographic atrophy or neovascular AMD) was found in 0.2% of individuals (stage 4a, 0.1 % [0.0-0.2]; stage 4b, 0.1% [0.0-0.2]). AMD increased significantly with age (odds ratio [OR], 1.09; 95% CI, 1.08-1.10). Sex, iris colour, and residence (rural vs. urban) were not associated with different rates of AMD.

CONCLUSIONS

In this study, the prevalence of AMD increased dramatically with age; however, although AMD is usually thought to occur after age 50, signs of early AMD were found in 3.8% of individuals in the youngest age group (younger than 45 years). This population-based sample is the first to provide substantial epidemiologic data from a large German cohort, including data on macular degeneration in younger age groups and incidence data after recall.