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Kráľová JŠ, Kolář P, Kapounová Z, Veselý P, Brázdová ZD. Lifestyle factors associated with age-related macular degeneration: Case-control study. Eur J Ophthalmol 2024; 34:1548-1554. [PMID: 38295331 DOI: 10.1177/11206721241229310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
BACKGROUND Age-related macular degeneration (AMD) is one of the major causes of vision loss in individuals aged ≥ 65 years in developed countries. This study aimed to determine the associations between modifiable risk factors and AMD. This is the first study describing the relationship between lifestyle factors and AMD in the Czech Republic. METHODS In this cross-sectional case-control study, 93 AMD cases and 58 controls without AMD and cataract were included. All participants were examined by Optical coherence tomography at the Clinic of Eye Treatment at the University Hospital Brno. Data were collected using a pre-tested self-report questionnaire in a face-to-face interview. RESULTS We found significant associations between those who were living in the city (OR 95% CI: 2.19 (1.0-4.6); p = 0,039), with a positive family history of AMD (OR 95% CI: 12.75 (1.6-98.6); p = 0,015), exposure to cigarette smoke (OR 95% CI: 2.72 (1.4-5.4); p = 0,004), and daily exposure to passive smoking (OR 95% CI: 2.29 (1.0-5.1); p = 0,045) and AMD. In men, we found significant associations between daily sunlight exposure (OR 95% CI: 2.98 (1.0-8.5); p = 0,041), short or long sleep duration (OR 95% CI: 3.98 (1.2-13.2); p = 0,024) and AMD. Men daily exposed to sunlight were at a 2.98 times higher risk of AMD than men with less than daily sunlight exposure. Men with short or long sleep duration (< 6 and > 8 h) were at a 3.98 times higher risk of AMD than men with recommended sleep duration of 6-8 h. CONCLUSIONS An increased risk of AMD was observed for living in the city, family history of AMD, exposure to cigarette smoke, and daily exposure to passive smoking. Increased risk of AMD was observed for daily sunlight exposure and short or long sleep duration; however, only in men.
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Affiliation(s)
- Jana Šalková Kráľová
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Petr Kolář
- Department of Ophthalmology, Slovak Medical University, and University Hospital Bratislava, Bratislava, Slovak Republic
| | - Zlata Kapounová
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Petr Veselý
- Department of Optometry and Orthoptics, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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Roshanshad A, Roshanshad R, Moosavi SA, Ardekani A, Nabavizadeh SS, Fereidooni R, Ashraf H, Vardanjani HM. Prevalence of age-related macular degeneration in Iran and its projections through 2050: a systematic review and meta-analysis. BMC Ophthalmol 2023; 23:484. [PMID: 38007475 PMCID: PMC10675929 DOI: 10.1186/s12886-023-03218-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 11/13/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Age-related Macular Degeneration (AMD) is one of the most common causes of vision loss. A substantial increase in the burden of AMD is expected in the aging populations, including the Iranians. We investigated the age and gender-specific prevalence of AMD and its determinants in Iran. METHODS We systematically searched international (PubMed, Scopus, Embase, etc.) and local (IranDoc, Magiran, etc.) online databases. We included cross-sectional or cohort studies, either clinic- or population-based, published on the prevalence of AMD among Iranians, with no limitation on age. Joanna Briggs Institute (JBI) tools for critical appraisal were used. Prevalence estimates are pooled by applying random-effects modeling. Subgroup analysis and meta-regression were performed. RESULTS Seventeen studies with 16,120 participants were included. Based on studies in general population, the pooled prevalence of AMD was 10.8% (95% CI: 6.5-16.2%) in males, and 9.8% (95% CI: 4.7-16.4%) in females. 8.5% of moderate vision impaired, 13.6% of severe vision impaired, and 15.7% of blind participants were affected by AMD. The prevalence of AMD was 2% in 40-49, and 32.3% in the ≥ 80 population. The prevalence of AMD was 11.9% among the visually impaired vs. 8.7% in the general population. The study's sampling method, location, and mean age were correlated with the heterogeneities of the prevalence. We observed an increasing trend in the number of AMD cases (average annual percent change = 3.66%; 95% CI: 3.65-3.67%) from 1990 to 2050. The expected number of AMD cases in Iran will be near 5.5 million by 2050. CONCLUSION The prevalence of AMD in Iran was somewhere between the prevalence of Asians and Europeans. Given the aging trend of the Iranian community and an average annual percent change of 3.66%, it is indispensable to adopt preventive and screening policies to diminish the burden of the disease in the future decades.
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Affiliation(s)
- Amirhossein Roshanshad
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- MPH Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Romina Roshanshad
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Ali Moosavi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Ardekani
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Sadat Nabavizadeh
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Otolaryngology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Fereidooni
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Ashraf
- Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Molavi Vardanjani
- MPH Department, Shiraz University of Medical Sciences, Shiraz, Iran.
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Heilenbach N, Hu G, Lamrani R, Prasad J, Ogunsola T, Iskander M, Elgin CY, McGowan R, Vieira D, Al-Aswad LA. Environmental influences on ophthalmic conditions: A scoping review. Clin Exp Ophthalmol 2023; 51:516-545. [PMID: 37309709 DOI: 10.1111/ceo.14262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/05/2023] [Accepted: 05/18/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Environmental factors have been implicated in various eye pathologies. The purpose of this review is to synthesise the published research on environmental effects on eye disease. METHODS Four databases were searched for terms relating to environmental exposures and ophthalmic disease. Titles and abstracts were screened followed by full-text review. Data was extracted from 118 included studies. Quality assessment was conducted for each study. RESULTS Air pollutants, including nitrogen dioxide, nitrites, sulphur dioxide, particulate matter, carbon monoxide, ozone and hydrocarbons are associated with ocular conditions ranging from corneal damage to various retinopathies, including central retinal artery occlusion. Certain chemicals and metals, such as cadmium, are associated with increased risk of age-related macular degeneration. Climate factors, such as sun exposure, have been associated with the development of cataracts. Living in rural areas was associated with various age-related eye diseases whereas people living in urban settings had higher risk for dry eye disease and uveitis. CONCLUSION Environmental exposures in every domain are associated with various ophthalmic conditions. These findings underscore the importance of continued research on the interplay between the environment and eye health.
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Affiliation(s)
- Noah Heilenbach
- Grossman School of Medicine, Department of Ophthalmology, New York University, New York, New York, USA
| | - Galen Hu
- Grossman School of Medicine, Department of Ophthalmology, New York University, New York, New York, USA
| | - Ryan Lamrani
- Department of Ophthalmology, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Jaideep Prasad
- Grossman School of Medicine, Department of Ophthalmology, New York University, New York, New York, USA
| | - Titilola Ogunsola
- Department of Ophthalmology, Howard University College of Medicine, Washington, District of Columbia, USA
| | - Mina Iskander
- Miller School of Medicine, Department of Medicine, University of Miami, Miami, Florida, USA
| | - Cansu Yuksel Elgin
- Department of Ophthalmology, Istanbul Universitesi-Cerrahpaşa, Istanbul, Turkey
| | - Richard McGowan
- Health Sciences Library, New York University, New York, New York, USA
| | - Dorice Vieira
- Health Sciences Library, New York University, New York, New York, USA
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Abdolrahimzadeh S, Di Pippo M, Sordi E, Cusato M, Lotery AJ. Subretinal drusenoid deposits as a biomarker of age-related macular degeneration progression via reduction of the choroidal vascularity index. Eye (Lond) 2023; 37:1365-1370. [PMID: 35739243 PMCID: PMC10169760 DOI: 10.1038/s41433-022-02134-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/09/2022] [Accepted: 06/09/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study aimed to analyse the role of the choroid in early age-related macular degeneration (AMD) by analysing choroidal vascularity index (CVI) in pure cohorts of patients with subretinal drusenoid deposits (SDD) or conventional drusen (CD). SUBJECTS/METHODS This was an observational cross-sectional study. Comprehensive ophthalmologic examination and multimodal imaging including fundus photography, autofluorescence, near infrared reflectance, and spectral domain optical coherence tomography (SDOCT) was performed. CVI processing was performed on a foveal horizontal SDOCT scan with binarization using Image J Image software and calculated as the ratio between luminal area (LA) and total area (TA). RESULTS Sixty-nine eyes of 69 participants were included; 23 eyes with SDD alone, 22 eyes with CD alone, and 24 control eyes of healthy age-matched subjects. CVI was significantly reduced in the SDD and CD group compared to controls (p = 0.0001). Post-hoc analysis revealed a significant reduction of CVI in the SDD versus the control group (p = 0.0002), in the CD versus the control group (p = 0.001), and in the SDD versus the CD group (p = 0.006). Covariance analysis showed a significant difference of LA (p = 0.033) but no significant difference of TA (p = 0.106) between the three groups. Direct comparison between CD and SDD showed a significant reduction of LA and TA in the SDD group. CONCLUSIONS CVI may have prognostic implications in early AMD. SDD is a biomarker of AMD progression and the mechanism for this could be via reduction of the CVI.
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Affiliation(s)
- Solmaz Abdolrahimzadeh
- Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy.
- St. Andrea Hospita, Via di Grottarossa 1035/1039, Rome, 00189, Italy.
| | - Mariachiara Di Pippo
- Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
| | - Edoardo Sordi
- Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
| | - Mattia Cusato
- Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
| | - Andrew John Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, SO16 6YD, UK
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Serra R, Rallo V, Pinna A, Steri M, Piras MG, Marongiu M, Coscas F, Gorospe M, Schlessinger D, Fiorillo E, Cucca F, Angius A. Polygenic risk score and biochemical/environmental variables predict a low-risk profile of age-related macular degeneration in Sardinia. Graefes Arch Clin Exp Ophthalmol 2023; 261:691-698. [PMID: 36264335 PMCID: PMC10601990 DOI: 10.1007/s00417-022-05858-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/17/2022] [Accepted: 10/02/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To ascertain the prevalence and clinical and genetic features of age-related macular degeneration (AMD) in subjects living in the Lanusei valley, Central Sardinia, Italy, involved in a study on ageing (SardiNIA project). METHODS A total of 814 volunteers aged ≥ 50 years, randomly selected from the SardiNIA project dataset, were included. A color fundus (CF) photograph of the 30° central retina of each eye was obtained and graded according to the Age-Related Eye Disease Study system. Life-style choices were investigated using standardized questionnaires. The concentrations of several inflammatory biomarkers (i.e., complement component, fibrinogen, and C-reactive protein) were measured. Polygenic risk score (PRS) was calculated and compared with results obtained from a European cohort. RESULTS A total of 756 subjects had gradable CF photographs for AMD detection. In 91.3%, no signs of AMD were observed. The prevalence rates of early and late AMDs were 6.9% and 0.6%, respectively. A total of 85% of subjects were physically active; only 13.5% were current smokers. Low concentrations of complement component, fibrinogen, and C-reactive protein were found. We calculated the polygenic risk scores (PRS) using 40 AMD markers distributed on several candidate genes in Europeans and Sardinians. The mean PRS value was significantly lower in Sardinians than in the Europeans (0.21 vs. 0.248, respectively, p = 1.18 × 10-77). CONCLUSIONS In our cohort, most subjects showed no sign of any AMD type and late AMD was a condition rarely observed. Results of genetic, biochemical, and life-style investigation support the hypothesis that Sardinia population may present of a peculiar background with a protective effect against AMD development.
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Affiliation(s)
- Rita Serra
- Institute of Genetic and Biomedical Research, National Research Council, Cittadella Universitaria Di Cagliari, c/o S.S 554 bivio per Sestu Km 4,500, 09042, Monserrato, Cagliari, Italy.
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
- Centre Ophtalmologique de L'Odeon, 113 bd Saint Germain, 75006, Paris, France.
| | - Vincenzo Rallo
- Institute of Genetic and Biomedical Research, National Research Council, Cittadella Universitaria Di Cagliari, c/o S.S 554 bivio per Sestu Km 4,500, 09042, Monserrato, Cagliari, Italy
| | - Antonio Pinna
- Department of Medicine, Surgery and Pharmacy, Ophthalmology Unit, University of Sassari, Sassari, Italy
| | - Maristella Steri
- Institute of Genetic and Biomedical Research, National Research Council, Cittadella Universitaria Di Cagliari, c/o S.S 554 bivio per Sestu Km 4,500, 09042, Monserrato, Cagliari, Italy
| | - Maria Grazia Piras
- Institute of Genetic and Biomedical Research, National Research Council, Cittadella Universitaria Di Cagliari, c/o S.S 554 bivio per Sestu Km 4,500, 09042, Monserrato, Cagliari, Italy
| | - Michele Marongiu
- Institute of Genetic and Biomedical Research, National Research Council, Cittadella Universitaria Di Cagliari, c/o S.S 554 bivio per Sestu Km 4,500, 09042, Monserrato, Cagliari, Italy
| | - Florence Coscas
- Centre Ophtalmologique de L'Odeon, 113 bd Saint Germain, 75006, Paris, France
| | - Myriam Gorospe
- Laboratory of Genetics and Genomics, National Institute On Aging, Baltimore, MD, USA
| | - David Schlessinger
- Laboratory of Genetics and Genomics, National Institute On Aging, Baltimore, MD, USA
| | - Edoardo Fiorillo
- Institute of Genetic and Biomedical Research, National Research Council, Cittadella Universitaria Di Cagliari, c/o S.S 554 bivio per Sestu Km 4,500, 09042, Monserrato, Cagliari, Italy
| | - Francesco Cucca
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Andrea Angius
- Institute of Genetic and Biomedical Research, National Research Council, Cittadella Universitaria Di Cagliari, c/o S.S 554 bivio per Sestu Km 4,500, 09042, Monserrato, Cagliari, Italy.
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Choi EY, Kim M, Lee CS, Byeon SH, Kim SS, Lee M. Intermittent Fasting Is Associated With a Decreased Risk of Age-Related Macular Degeneration. Am J Ophthalmol 2022; 243:1-9. [PMID: 35809657 DOI: 10.1016/j.ajo.2022.06.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/15/2022] [Accepted: 06/22/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE To investigate the association between intermittent fasting and age-related macular degeneration (AMD) in the general older adult population. DESIGN A cross-sectional study using a population-based, government-led survey data, Korean National Health and Nutrition Examination Survey (KNHANES). METHODS A total of 4504 individuals aged ≥55 years with comprehensive data including meal frequency and fundus photography were selected using the KNHANES 2015-2018 database. Participants were divided into 2 groups based on breakfast frequency per week; intermittent fasting (nearly 0 time/week) and nonfasting (5-7 times/week) groups. Multiple logistic regression analysis was performed to determine the risk factors for AMD identified by fundus photography. RESULTS AMD was identified in 25.1% of total participants. The intermittent fasting group had a decreased risk of AMD compared with the nonfasting group (adjusted odds ratio [aOR] 0.413, 95% CI 0.203-0.841), especially in individuals with a younger age (<70 years, aOR 0.357, 95% CI 0.153-0.833), obesity (aOR 0.663, 95% CI 0.424-1.037), and urban residence (aOR 0.437, 95% CI 0.248-0.769). Increased age (aOR 1.058, 95% CI 1.041-1.076) and serum high-density lipoprotein levels (aOR 1.011, 95% CI 1.002-1.021) were also independent risk factors for AMD. CONCLUSIONS Using the population-based survey data, we demonstrated that intermittent fasting by skipping breakfast was significantly associated with a reduced risk of AMD in a representative older adult population, especially in individuals with age <70 years, obesity, and urban residence.
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Affiliation(s)
- Eun Young Choi
- Department of Ophthalmology, Gangnam Severance Hospital, Institute of Vision Research (E.Y.C., M.K.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Kim
- Department of Ophthalmology, Gangnam Severance Hospital, Institute of Vision Research (E.Y.C., M.K.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Christopher Seungkyu Lee
- Department of Ophthalmology, Severance Eye Hospital, Institute of Vision Research (C.S.L., S.H.B., S.S.K.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk Ho Byeon
- Department of Ophthalmology, Severance Eye Hospital, Institute of Vision Research (C.S.L., S.H.B., S.S.K.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Severance Eye Hospital, Institute of Vision Research (C.S.L., S.H.B., S.S.K.), Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minyoung Lee
- Department of Internal Medicine (M.L.), Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Endocrine Research (M.L.), Yonsei University College of Medicine, Seoul, Republic of Korea.
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Mastropasqua L, D’Aloisio R, Mastrocola A, Perna F, Cerino L, Cerbara L, Cruciani F, Toto L. Epidemiological Surveillance of Eye Disease and People Awareness in the Abruzzo Region, Italy. MEDICINA-LITHUANIA 2021; 57:medicina57090978. [PMID: 34577901 PMCID: PMC8465192 DOI: 10.3390/medicina57090978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/01/2021] [Accepted: 09/13/2021] [Indexed: 11/28/2022]
Abstract
Background and Objectives: Vision impairments and related blindness are major public health problems. The prevalence of eye disease and barriers to optimal care markedly vary among different geographic areas. In the Abruzzo region (central Italy), an epidemiological surveillance on the state of ocular health in the population aged over 50 years was performed in 2019. Materials and Methods: Participants were sampled to be representative of the region’s inhabitants. Data were collected through a telephone interview and an eye examination. Prevalence of cataract, glaucoma, retinopathy, and maculopathy was assessed. The Cohen’s kappa (k) was used to measure the agreement between the presence of eye disease and awareness of the disease by the participants. Results: Overall, 983 people with a mean age of 66.0 ± 9.5 years were included in the study. The prevalence of cataracts, glaucoma, maculopathy, and retinopathy was 52.6%, 5.3%, 5.6%, and 29.1%, respectively. Among the total of the affected people, those aware of their condition were 21.8% (k = 0.12, slight agreement) for cataract, 65.4% (k = 0.78, substantial agreement) for glaucoma, 7.1% (k = 0.10, slight agreement) for maculopathy, and 0% for retinopathy (k = −0.004, agreement lower than that expected by chance). Refractive defects were corrected in the vast majority of participants. Conclusion: In the Abruzzo region, about two thirds of citizens aged 50 years or over suffer from cataract, glaucoma, retinopathy, or maculopathy, which are recognized as leading causes of blindness. Many people with eye disease do not know they have it. These data can be used by clinicians and policymakers to undertake clinical, political, and social actions.
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Affiliation(s)
- Leonardo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
| | - Rossella D’Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
- Correspondence:
| | - Alessandra Mastrocola
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
| | - Fabiana Perna
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
- Italian National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired-WHOCC, IAPB Italy Onlus-FPG IRCCS, 00185 Roma, Italy;
| | - Luca Cerino
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
| | - Loredana Cerbara
- Institute for Research on Population and Social Policies, Italian National Research Council (CNR-IRPPS), 00185 Rome, Italy;
| | - Filippo Cruciani
- Italian National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired-WHOCC, IAPB Italy Onlus-FPG IRCCS, 00185 Roma, Italy;
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D’Annunzio Chieti-Pescara, 66100 Chieti, Italy; (L.M.); (A.M.); (F.P.); (L.C.); (L.T.)
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Yip JLY, Muthy Z, Peto T, Lotery A, Foster PJ, Patel P. Socioeconomic risk factors and age-related macular degeneration in the UK Biobank study. BMJ Open Ophthalmol 2021; 6:e000585. [PMID: 33693059 PMCID: PMC7907888 DOI: 10.1136/bmjophth-2020-000585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/26/2020] [Accepted: 01/24/2021] [Indexed: 12/26/2022] Open
Abstract
Objective There is contrasting evidence on the relationship between socioeconomic status (SES) and age-related macular degeneration (AMD), the most common cause of visual impairment (VI) in developed countries. This study examines the relationship between SES, cardiovascular risk factors and self-reported AMD. Methods and analysis Over 500000 people participated in the UK Biobank study from 2006 to 2019, with sociodemographic data and clinical measurements collected using standardised procedures. Visual acuity was measured in 117907 participants with VI defined as LogMAR ≤0.3. We used logistic regression to examine the cross-sectional associations between SES and self-reported AMD. Results Self-reported AMD was available for 133339 participants aged 50 and older. People reporting AMD had higher academic qualifications, lower income, were unable to work due to disability, have higher BMI, diabetes and vascular heart disease after adjusting for age and sex. In a multivariable analysis, higher income was protective of AMD and economic inactivity due to disability increased the odds of AMD (2.02, 95% CI 1.13 to 3.61). Both associations were independent of cardiovascular factors, but was no longer significant after adjusting for VI. Conclusions The association between education, employment and household income with AMD was independent of cardiovascular risk factors.
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Affiliation(s)
- Jennifer Lai Yee Yip
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Zaynah Muthy
- Institute of Ophthalmology, UCL, London, UK.,NIHR Moorfields Biomedical Research Centre, London, Greater London, UK
| | - Tunde Peto
- Centre for Public Health, Blackwell's Queen's University Belfast, Belfast, UK
| | - Andrew Lotery
- Faculty of Medicine, University of Southampton, Southampton, Hampshire, UK
| | - Paul J Foster
- Institute of Ophthalmology, UCL, London, UK.,NIHR Moorfields Biomedical Research Centre, London, Greater London, UK
| | - Praveen Patel
- Institute of Ophthalmology, UCL, London, UK.,NIHR Moorfields Biomedical Research Centre, London, Greater London, UK
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Li JQ, Welchowski T, Schmid M, Mauschitz MM, Holz FG, Finger RP. Prevalence and incidence of age-related macular degeneration in Europe: a systematic review and meta-analysis. Br J Ophthalmol 2020; 104:1077-1084. [PMID: 31712255 DOI: 10.1136/bjophthalmol-2019-314422] [Citation(s) in RCA: 171] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/28/2019] [Accepted: 10/13/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND/AIMS Age-related macular degeneration (AMD) is the main cause of visual impairment and blindness in Europe. A further increase in the number of affected persons is expected and current European data are needed for healthcare resource planning. METHODS We performed a systematic review on the prevalence and incidence of AMD based on the meta-analysis of observational studies in epidemiology guideline. Meta-analysis and meta-regression on time-trends, age, countries, regions, sex and classification systems for AMD were performed. Based on Eurostat population projections, the pooled prevalence estimates were extrapolated to the year 2050. RESULTS Twenty-two prevalence and four incidence studies published since 1996 were included. Our pooled prevalence estimate of early or intermediate AMD and any late AMD in those 60 years and older was 25.3% (95% CI 18.0% to 34.4%) and 2.4% (95% CI 1.8% to 3.3%), respectively. A significant increase in prevalence was seen in older populations. In the meta-analysis of incidence, the pooled annual incidence of any late AMD was 1.4 per 1 000 individuals (95% CI 0.8 to 2.6). Overall, the number of EU inhabitants with any AMD is expected to increase from 67 to 77 million until 2050. Incident late AMD is estimated to increase from 400 000 per year today to 700 000 per year in 2050. CONCLUSIONS Approximately 67 million people in the EU are currently affected by any AMD and, due to population ageing, this number is expected to increase by 15% until 2050. Monitoring and treatment of people with advanced disease stages will require additional healthcare resources and thorough healthcare planning in the years and decades to come.
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Affiliation(s)
- Jeany Q Li
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Thomas Welchowski
- Department of Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
| | - Matthias Schmid
- Department of Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany
| | | | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Robert P Finger
- Department of Ophthalmology, University of Bonn, Bonn, Germany
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Scuteri D, Vero A, Zito M, Naturale MD, Bagetta G, Nucci C, Tonin P, Corasaniti MT. Diabetic retinopathy and age-related macular degeneration: a survey of pharmacoutilization and cost in Calabria, Italy. Neural Regen Res 2019; 14:1445-1448. [PMID: 30964071 PMCID: PMC6524505 DOI: 10.4103/1673-5374.253528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 01/24/2019] [Indexed: 02/07/2023] Open
Abstract
The aged population is constantly growing, thus fostering an increase in age-dependent diseases. Among these, diabetic retinopathy (DR) along with age-related macular degeneration entails progressive vision loss. Since such conditions are associated with the proliferation of novel vessels, their pharmacotherapeutic management consists of the intravitreal injection of anti-vascular endothelial growth factor drugs, able to hinder the driving of vascular proliferation prompted by vascular endothelial growth factor. The humanized anti-vascular endothelial growth factor monoclonal antibody ranibizumab provided evidence for efficacy in several trials, hence earning approval by the US Food and Drug Administration for therapeutic use in all the stages of DR. Due to the lack of epidemiologic and pharmacoeconomic evaluation in the local Calabria Region context, the present retrospective observational study focused on prevalence of DR and age-related macular degeneration, treatment and cost of therapy with ranibizumab in 870 patients arriving to clinical observation at the "Mater Domini" University Hospital in Calabria, Italy from January 2014 to June 2017. Data were extracted from the database of ophthalmology ward and subjected to statistical analysis. The results suggest that the most frequent retinal diseases are age-related macular degeneration and DR and that the use of ranibizumab has been decreasing over the 4-year study period together with the associated cost per patient which was similar for both disorders. Therefore, appropriateness of treatment with drugs other than ranibizumab needs to be assessed in this setting and deep monitoring of pharmacologic treatment for retinal diseases is necessary to prevent or delay visual acuity decrease and complete vision loss. Study procedures were performed in accordance with the "Mater Domini" University Hospital ethical standards of the responsible committee on human experimentation.
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Affiliation(s)
- Damiana Scuteri
- Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, Rende (Cosenza), Italy
| | - Ada Vero
- Pharmacy Unit, “Mater Domini” University Hospital, Catanzaro, Italy
| | | | - Maria Diana Naturale
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Giacinto Bagetta
- Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, Rende (Cosenza), Italy
| | - Carlo Nucci
- Ophtalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Paolo Tonin
- S. Anna Institute, Regional Center for Serious Brain Injuries, Crotone, Italy
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Bandello F, Staurenghi G, Ricci F, Midena E, Viola F, Lupieri Sinibaldi T, Colombo L, Peruzzi E, Bassanini S. Safety and tolerability of ranibizumab in uni/bilateral neovascular age-related macular degeneration: 12-month TWEYEs study. Br J Ophthalmol 2019; 104:64-73. [PMID: 31079057 PMCID: PMC6922014 DOI: 10.1136/bjophthalmol-2019-313907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 03/29/2019] [Indexed: 02/07/2023]
Abstract
Background To evaluate the safety and tolerability of ranibizumab 0.5 mg in patients with uni/bilateral neovascular age-related macular degeneration (nAMD) and best-corrected visual acuity (BCVA)<2/10 and/or second eye affected, regardless of BCVA. Methods In this 12-month, prospective, multicentre, open-label, single arm, pragmatic interventional study, patients (N=941) aged ≥ 50 years were to receive ranibizumab as per approved label, monthly until maximum stable visual acuity (VA) was achieved (initially, three or more injections may be required). Thereafter, patients were to be monitored monthly for VA and treatment was to be resumed if VA was reduced due to disease activity. Results Of the 936 patients treated with ranibizumab at least once during the study, 823/113 were unilaterally/bilaterally (not simultaneously) treated. The mean (SD) number of ranibizumab injections during the study was 5.4 (2.9)/10.6 (5.0) injections in uni/bilaterally treated patients. Three systemic drug-related adverse events (AEs) (all serious, all in unilaterally treated patients) and 18 systemic AE of special interest (AESIs) (11 serious, 16/2 in unilaterally/bilaterally treated patients) occurred during the study. The annual incidence rate (AIR) (events/1000 person-years) for systemic drug-related AEs, considering a 15-day/30-day risk period, 11.0/8.5 for unilaterally treated patients. Considering the same risk period, the AIR (events/1000 person-years) for systemic AESIs for unilaterally treated patients was 22.1/19.9. Considering a 30-day risk period, the AIR (events/1000 treated eye-years) of ocular drug-related AEs was 23 and AESIs was 11.5. Conclusions The low incidence of AEs and AESIs demonstrated the good safety and tolerability of ranibizumab in unilaterally/bilaterally treated patients with nAMD in this real-world setting.
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Affiliation(s)
- Francesco Bandello
- Department of Ophthalmology, University Vita Salute Hospital San Raffaele, Milano, Italy
| | - Giovanni Staurenghi
- Department of Biomedical and Clinical Science Luigi Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy
| | - Federico Ricci
- UOSD Patologie Retiniche, Policlinico Tor Vergata, University Tor Vergata, Rome, Italy
| | - Edoardo Midena
- Department of Ophthalmology, University of Padua, Padova, Italy
| | - Francesco Viola
- Department of Clinical Sciences and CommunityHealth, University of Milan, Ophthalmological Unit, IRCCS-Cà GrandaFoundation-Ospedale Maggiore Policlinico, Milano, Italy
| | | | - Laura Colombo
- Novartis Farma S.p.A, Largo Umberto Boccioni, Origgio, Origgio, Italy
| | - Elena Peruzzi
- Novartis Farma S.p.A, Largo Umberto Boccioni, Origgio, Origgio, Italy
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Miotto S, Zemella N, Gusson E, Panozzo G, Saviano S, Scarpa G, Boschi G, Piermarocchi S. Morphologic Criteria of Lesion Activity in Neovascular Age-Related Macular Degeneration: A Consensus Article. J Ocul Pharmacol Ther 2017; 34:298-308. [PMID: 29148864 PMCID: PMC5899278 DOI: 10.1089/jop.2017.0022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Intravitreal antivascular endothelial growth factor drugs represent the current standard of care for neovascular age-related macular degeneration (nAMD). Individualized treatment regimens aim at obtaining the same visual benefits of monthly injections with a reduced number of injections and follow-up visits, and, consequently, of treatment burden. The target of these strategies is to timely recognize lesion recurrence, even before visual deterioration. Early detection of lesion activity is critical to ensure that clinical outcomes are not compromised by inappropriate delays in treatment, but questions remain on how to effectively monitor the choroidal neovascularization (CNV) activity. To assess the persistence/recurrence of lesion activity in patients undergoing treatment for nAMD, an expert panel developed a decision algorithm based on the morphological features of CNV. After evaluating all current retinal imaging techniques, the panel identified optical coherent tomography as the most reliable tool to ascertain lesion activity when funduscopy is not obvious.
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Affiliation(s)
- Stefania Miotto
- 1 Department of Ophthalmology, Camposampiero Hospital, ULSS 6 Euganea , Padua, Italy
| | - Nicola Zemella
- 2 Department of Ophthalmology, Mestre Hospital, ULSS 3 Serenissima , Venice, Italy
| | - Elena Gusson
- 3 Department of Ophthalmology, University of Verona , Verona, Italy
| | - Giacomo Panozzo
- 4 Department of Ophthalmology, Bussolengo Hospital, ULSS 9 Scaligera , Verona, Italy
| | - Sandro Saviano
- 5 Department of Ophthalmology, University of Trieste , Trieste, Italy
| | - Giuseppe Scarpa
- 6 Department of Ophthalmology, Ca Foncello Hospital, ULSS 2 Marca Trevigiana , Treviso, Italy
| | - Giorgio Boschi
- 6 Department of Ophthalmology, Ca Foncello Hospital, ULSS 2 Marca Trevigiana , Treviso, Italy
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Multiple deprivation, vision loss, and ophthalmic disease in adults: global perspectives. Surv Ophthalmol 2017; 63:406-436. [PMID: 29100897 DOI: 10.1016/j.survophthal.2017.10.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 10/19/2017] [Accepted: 10/19/2017] [Indexed: 12/19/2022]
Abstract
The association between socioeconomic position and morbidity and mortality has long been recognized. We evaluate the evidence for an association between multiple aspects of deprivation and ocular health in a global context. This is a systematic review of studies that evaluated deprivation in the adult population in the context of the major acquired causes of visual loss such as cataract, diabetic eye disease, glaucoma, age-related macular degeneration, and ocular trauma. The search strategy identified relevant studies reported between 1946 and August 2016, with randomized control trials, case-control, cohort, and cross-sectional study designs being selected for inclusion. The studies identified in this review from across the world demonstrate the extent to which the common themes such as low educational attainment and low income may be associated with increased incidence of various sight-threatening conditions and may adversely affect access to specialist assessment and delivery of treatment. Health inequality may always persist, but an increased recognition of the importance of the various impacts of deprivation may empower policy makers to target limited resources to the most vulnerable groups in order to deliver the greatest benefit.
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Hashemi H, Khabazkhoob M, Nabovati P, Ostadimoghaddam H, Shafaee S, Doostdar A, Yekta A. The Prevalence of Age-Related Eye Disease in an Elderly Population. Ophthalmic Epidemiol 2017; 24:222-228. [DOI: 10.1080/09286586.2016.1270335] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Payam Nabovati
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Hadi Ostadimoghaddam
- Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shokrolah Shafaee
- Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asgar Doostdar
- Department of Optometry, Iran University of Medical Sciences, Tehran, Iran
| | - AbbasAli Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
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15
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Cachulo MDL, Laíns I, Lobo C, Figueira J, Ribeiro L, Marques JP, Costa J, Vieira A, Rodrigues J, Alves D, Nunes S, Costa M, Rodrigues V, Cunha-Vaz J, Delcourt C, Silva R. Age-related macular degeneration in Portugal: prevalence and risk factors in a coastal and an inland town. The Coimbra Eye Study - Report 2. Acta Ophthalmol 2016; 94:e442-53. [PMID: 26806024 DOI: 10.1111/aos.12950] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 11/05/2015] [Indexed: 01/22/2023]
Abstract
PURPOSE To determine the age- and sex-specific prevalence of early and late age-related macular degeneration (AMD) in two Portuguese population-based samples and to identify its risk factors. POPULATION A population of 6023 adults aged ≥55 years was recruited from two Portuguese primary healthcare units in the central region of Portugal - one from a coastal (n = 3000) and another from an inland town (n = 3023). METHODS Cross-sectional population-based study. Participants were enrolled in the two locations between August 2009 and October 2013. Responders underwent standardized interviews and ophthalmologic examination, including digital fundus imaging. All fundus photographs were graded according to an International Classification and Grading System. The main outcome measures consisted of age- and sex-adjusted prevalence of early and late AMD. Potential epidemiologic risk factors were also evaluated using logistic regression analysis. RESULTS Of the 6023 subjects enrolled, 5996 had gradable fundus images and were included in the analysis. The crude prevalence of early and late AMD was 6.99 and 0.67%, respectively, for the coastal town and 15.39 and 1.29% for the inland town. Age- and sex-adjusted prevalence of any AMD for the Portuguese population was 12.48% (95% CI: 11.61-13.33) with late AMD accounting for 1.16% (95% CI: 0.85-1.46). Neovascular AMD (NV-AMD) and geographic atrophy (GA) accounted for 0.55% (95% CI: 0.36-0.75) and 0.61% (95% CI: 0.37-0.84) of individuals, respectively. After adjusting for possible confounding factors, prevalence of early and late AMD increased with increasing age (OR = 1.35; 95% CI: 1.23-1.49 for early and OR = 3.01; 95% CI: 2.22-4.08 for late AMD, per each decade of age increase, p < 0.001). After adjustment for age, sex, family history, smoking history, hypertension, diabetes and BMI, subjects from the inland town presented a significantly higher OR of early and late AMD than subjects from the coastal town (OR = 2.57, 95% CI: 2.12-3.12, p < 0.001 for early and OR = 2.06, 95% CI: 1.07-3.95, p = 0.029 for late AMD). CONCLUSIONS The prevalence of early and late AMD in this Portuguese population was similar to other large-scale population-based cohorts. After controlling for confounders, age and study site of inclusion were significant independent predictors for both early and late forms of the disease. Further analysis will be needed to completely unravel the underlying reasons for this difference regarding geographic location.
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Affiliation(s)
- Maria da Luz Cachulo
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - Inês Laíns
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - Conceição Lobo
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - João Figueira
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - Luísa Ribeiro
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - João P. Marques
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
| | - José Costa
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
| | | | - João Rodrigues
- Primary Health Care Unit of Lousã; Unidade de Saúde Familiar da Serra da Lousã e Trevim Sol; Coimbra Portugal
| | - Dalila Alves
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Sandrina Nunes
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Miguel Costa
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Victor Rodrigues
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
- Instituto de Higiene e Medicina Social of the Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
| | - José Cunha-Vaz
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | | | - Rufino Silva
- Ophthalmology Department; Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
- Faculty of Medicine - University of Coimbra (FMUC); Coimbra Portugal
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Raman R, Pal SS, Ganesan S, Gella L, Vaitheeswaran K, Sharma T. The prevalence and risk factors for age-related macular degeneration in rural-urban India, Sankara Nethralaya Rural-Urban Age-related Macular degeneration study, Report No. 1. Eye (Lond) 2016; 30:688-97. [PMID: 26915746 DOI: 10.1038/eye.2016.14] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 12/08/2015] [Indexed: 11/09/2022] Open
Abstract
PurposeTo report the age- and gender-adjusted prevalence rates of early and late age-related maculopathy (ARM) and associated risk factors in rural and urban Indian population.MethodsA population-based cross-sectional study was carried out in South India between 2009 and 2011. Of the 6617 subjects ≥60 years enumerated ones, 5495 (83.04%) participated in the eye examination. A detailed history including data on demographic, socioeconomic, and ocular history was obtained. Participants underwent detailed ophthalmic evaluation including 30° 3-field photograph as per Age-Related Eye Disease Study protocol. The ARM was graded according to the International ARM Epidemiological Study Group.ResultsAge- and gender-adjusted prevalence of early ARM was 20.91% (20.86-20.94) in the rural population and 16.37% (16.32-16.42) in the urban population. Similarly, the prevalence of late ARM was 2.26% (2.24-2.29) and 2.32% (2.29-2.34) in the rural and urban population, respectively. In both rural and urban populations, risk factors that were related to both early and late ARM were age, per year increase (OR, range 1.00-1.08); middle socioeconomic status (OR, range 1.05-1.83); and smokeless tobacco (OR, range 1.11-2.21). Protective factor in both was the presence of diabetes mellitus in all ARM (OR, range 0.34-0.83). Risk factors, only in the rural arm, were female gender (OR, range 1.06-1.64), past smoker (OR, 1.14), and serum low-density lipoprotein cholesterol level (OR, 1.03).ConclusionsThe study reports smokessless tobacco as a risk factor for both early and late ARM and identified a higher prevalence of early ARM in the rural population compared with urban population.
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Affiliation(s)
- R Raman
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Vision Research Foundation, Chennai, Tamil Nadu, India
| | - S S Pal
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Vision Research Foundation, Chennai, Tamil Nadu, India
| | - S Ganesan
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Vision Research Foundation, Chennai, Tamil Nadu, India
| | - L Gella
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Vision Research Foundation, Chennai, Tamil Nadu, India.,Elite School of Optometry, Chennai, Tamil Nadu, India
| | - K Vaitheeswaran
- Department of Preventive Ophthalmology, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - T Sharma
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Vision Research Foundation, Chennai, Tamil Nadu, India
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Reibaldi M, Longo A, Pulvirenti A, Avitabile T, Russo A, Cillino S, Mariotti C, Casuccio A. Geo-Epidemiology of Age-Related Macular Degeneration: New Clues Into the Pathogenesis. Am J Ophthalmol 2016; 161:78-93.e1-2. [PMID: 26432929 DOI: 10.1016/j.ajo.2015.09.031] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 09/24/2015] [Accepted: 09/24/2015] [Indexed: 12/25/2022]
Abstract
PURPOSE To evaluate the demographic, geographic, and race-related variables that account for geographic variability in prevalence rates of age-related macular degeneration (AMD). DESIGN Systematic review, meta-regression, and decision-tree analysis. METHODS A systematic literature review of PubMed, Medline, Web of Science, and Embase databases identified population-based studies on the prevalence of AMD published before May 2014. Only population-based studies that took place in a spatially explicit geographic area that could be geolocalized, and used retinal photographs and standardized grading classifications, were included. Latitude and longitude data (geolocalization) and the mean annual insolation for the area where survey took place were obtained. Age-standardized prevalence rates across studies were estimated using the direct standardization method. Correlations between the prevalence of AMD and longitude and latitude were obtained by regression analysis. A hierarchical Bayesian meta-regression approach was used to assess the association between the prevalence of AMD and other relevant factors. We further investigated the interplay between location and these factors on the prevalence of AMD using regression based on conditional-inference decision trees. RESULTS We observed significant inverse correlations between latitude or longitude, and crude or age-standardized prevalence rates, of early and late AMD (P < .001). Metaregression analysis showed that insolation, latitude, longitude, age, and race have a significant effect on the prevalence rates of early and late AMD (P < .001). Decision-tree analysis identified that the most important predictive variable was race for early AMD (P = .002) and insolation for late AMD (P = .001). CONCLUSIONS Geographic position and insolation are key factors in the prevalence of AMD.
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Piermarocchi S, Tognetto D, Piermarocchi R, Masetto M, Monterosso G, Segato T, Cavarzeran F, Turrini A, Peto T. Risk Factors and Age-Related Macular Degeneration in a Mediterranean-Basin Population: The PAMDI (Prevalence of Age-Related Macular Degeneration in Italy) Study - Report 2. Ophthalmic Res 2015; 55:111-8. [DOI: 10.1159/000441795] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 10/19/2015] [Indexed: 11/19/2022]
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19
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Akuffo KO, Nolan J, Stack J, Moran R, Feeney J, Kenny RA, Peto T, Dooley C, O'Halloran AM, Cronin H, Beatty S. Prevalence of age-related macular degeneration in the Republic of Ireland. Br J Ophthalmol 2015; 99:1037-44. [PMID: 25712825 PMCID: PMC4518752 DOI: 10.1136/bjophthalmol-2014-305768] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 01/08/2015] [Indexed: 11/05/2022]
Abstract
Background Age-related macular degeneration (AMD) remains the most common cause of visual loss among subjects over 50 years of age in the developed world. The Irish Longitudinal study on Ageing (TILDA) is a population-based study of subjects aged 50 years or older, designed to investigate factors that influence ageing, and has enabled this investigation of the prevalence of AMD in the Republic of Ireland (ROI). Methods Data collected from a nationally representative sample of community-living older adults aged 50 years and over in ROI over the period November 2009 to July 2011. 5035 participants attended the TILDA health centre for assessment. Retinal photographs were obtained in 4859 of these participants. Retinal grading was performed in a masked fashion using a modified version of the International Classification and Grading System for AMD. Results Adjusting for lower response rates among older subjects, the estimated overall prevalence of any AMD was 7.2% (95% CI 6.5% to 7.9%) in the population aged 50 years or older. The estimated prevalence of early AMD was 6.6% (95% CI 5.9% to 7.3%), and the estimated prevalence of late AMD was 0.6% (95% CI 0.4% to 0.8%). Statistically significant associations with AMD included increasing age and family history of the condition. Conclusions This is the first study to provide prevalence estimates of AMD in ROI and will inform eye care professionals and policymakers involved in the delivery and planning of care for those afflicted with this condition.
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Affiliation(s)
- Kwadwo Owusu Akuffo
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - John Nolan
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Jim Stack
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Rachel Moran
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Joanne Feeney
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, Trinity College, Dublin, Ireland Centre for Public Health, Queen's University Belfast, United Kingdom
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, Trinity College, Dublin, Ireland
| | - Tunde Peto
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | - Cara Dooley
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, Trinity College, Dublin, Ireland
| | - Aisling M O'Halloran
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, Trinity College, Dublin, Ireland
| | - Hilary Cronin
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, Trinity College, Dublin, Ireland
| | - Stephen Beatty
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
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Cachulo MDL, Lobo C, Figueira J, Ribeiro L, Laíns I, Vieira A, Nunes S, Costa M, Simão S, Rodrigues V, Vilhena N, Cunha-Vaz J, Silva R. Prevalence of Age-Related Macular Degeneration in Portugal: The Coimbra Eye Study - Report 1. Ophthalmologica 2015; 233:119-27. [PMID: 25677077 DOI: 10.1159/000371584] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 11/27/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the age- and gender-specific prevalence of early and late age-related macular degeneration (AMD) in a Portuguese population-based sample. METHODS All patients aged ≥55 years of a Portuguese primary health-care unit were recruited for a cross-sectional population-based study. Responders underwent complete ophthalmological examination and digital fundus imaging. Early and late AMD was defined according to the International Age-Related Macular Epidemiological Study Group Classification, and the adopted staging for AMD was the same as that used in the Rotterdam study. The age- and gender-adjusted prevalence of early and late forms of AMD was calculated. RESULTS Of the 4,370 eligible subjects, 3,000 underwent study procedures (68.6% response rate) and 2,975 were included in the analysis; they had a mean age of 68.9 ± 8.6 years. The overall prevalence of early and late AMD was 15.53% (95% CI 14.25-16.88) and 0.67% (95% CI 0.41-1.04), respectively. Neovascular AMD (NV-AMD) and geographic atrophy (GA) accounted for 0.44% (95% CI 0.23-0.75) and 0.27% (95% CI 0.12-0.53) of individuals, respectively. The highest prevalence of advanced AMD was among those aged ≥75 years (1.13% for NV-AMD; 0.63% for GA). CONCLUSIONS To our knowledge, this is the first AMD epidemiological study in a Portuguese population. The early forms of the disease had a similar prevalence to that of other large-scale population-based cohorts, but late AMD was less frequent than previously reported.
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Affiliation(s)
- Maria da Luz Cachulo
- Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Korb CA, Kottler UB, Wolfram C, Hoehn R, Schulz A, Zwiener I, Wild PS, Pfeiffer N, Mirshahi A. Prevalence of age-related macular degeneration in a large European cohort: results from the population-based Gutenberg Health Study. Graefes Arch Clin Exp Ophthalmol 2014; 252:1403-11. [PMID: 24566902 DOI: 10.1007/s00417-014-2591-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 01/23/2014] [Accepted: 02/04/2014] [Indexed: 11/25/2022] Open
Abstract
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.
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Affiliation(s)
- Christina A Korb
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, Langenbeckstr.1, 55131, Mainz, Germany,
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