Five-year incidence, progression, and risk factors for age-related macular degeneration: the age, gene/environment susceptibility study.

• Published in: Ophthalmology
• Main Authors: Jonasson, Fridbert, Fisher, Diana E, Eiriksdottir, Gudny, Sigurdsson, Sigurdur, Klein, Ronald, Launer, Lenore J, Harris, Tamara, Gudnason, Vilmundur, Cotch, Mary Frances
• Other Authors: Department of Ophthalmology, Landspitali University Hospital, Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland. Electronic address: [e-mail]. 2Division of Epidemiology and Clinical Applications, National Eye Institute, Bethesda, Maryland. 3Icelandic Heart Association, Kopavogur, Iceland. 4Ophthalmology and Visual Sciences, University of Wisconsin Madison, Madison, Wisconsin. 5Laboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute of Aging, Bethesda, Maryland. 6Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Icelandic Heart Association, Kopavogur, Iceland.
• Format: Article in Journal/Newspaper
• Language: English
• Published: American Academy of Ophthalmology 2014
• Subjects: Sjónhimna; Augnsjúkdómar; Arfgengi; Macular Degeneration*/epidemiology; Risk Factors; Prospective Studies; Gene-Environment Interaction; Age Factors; Aged; 80 and over; Biological Markers; Body Mass Index; Cholesterol; HDL/blood; Disease Progression; Female; Humans; Iceland/epidemiology; Incidence; Macular Degeneration*/etiology; Male; Multivariate Analysis; Smoking/adverse effects; Iceland
• Online Access: http://hdl.handle.net/2336/326078; https://doi.org/10.1016/j.ophtha.2014.03.013

To access publisher's full text version of this article click on the hyperlink at the bottom of the page To investigate the incidence and progression of age-related macular degeneration (AMD) and associated risk factors. Population-based, prospective, cohort study. We included 2868 participants from the Age Gene/Environment Susceptibility-Reykjavik Study with retinal data at baseline and 5-year follow-up. Digital macular photographs were graded for presence of AMD. Participants completed a questionnaire and extensive clinical battery. Biomarkers were assessed. Risk factors for AMD were analyzed using multivariate regression analysis with odds ratios (ORs) and 95% CIs. We assessed AMD, defined as early or late. Among 2196 participants free of AMD at baseline, 14.9% developed incident AMD. In multivariate models, incident AMD was significantly associated with age (OR per year, 1.14; 95% CI, 1.11-1.17), current smoking (OR, 2.07; 95% CI, 1.38-3.11), former smoking (OR, 1.36; 95% CI, 1.04-1.79), plasma high-density lipoprotein (HDL) cholesterol level (OR, 1.62 per mmol/L; 95% CI, 1.19-2.22), and body mass index (BMI; OR, 1.04 per kg/m(2); 95% CI, 1.01-1.07). Among 563 participants with early AMD at baseline, 22.7% progressed to late AMD (11.0% pure geographic atrophy [GA] and 11.7% exudative AMD). On multivariate analyses, age was significantly associated with progression to GA (OR 1.14; 95% CI, 1.07-1.21) and exudative AMD (OR, 1.08; 95% CI, 1.01-1.14). Adjusting for age, female sex was associated with exudative AMD (OR, 2.10; 95% CI, 1.10-3.98) and plasma HDL cholesterol with GA (OR, 2.03 per mmol/L; 95% CI, 1.02-4.05). By age 85, 57.4% of participants had signs of AMD. Age, smoking, plasma HDL cholesterol, BMI, and female sex are associated with AMD. Elevated HDL cholesterol is associated with GA development.