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Cited by 638Retinal Diseases and TreatmentsRetinal Imaging and AnalysisDementia and Cognitive Impairment Research

Fifteen-Year Cumulative Incidence of Age-Related Macular Degeneration

Klein, Ronald, Klein, Barbara E.K., Knudtson, Michael D., Meuer, Stacy M., Swift, Maria, Gangnon, Ronald E.·2007·Ophthalmology
DOI 10.1016/j.ophtha.2006.10.040
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Abstract

Purpose To describe the 15-year cumulative incidence of signs of early and late age-related macular degeneration (AMD).Design Population-based cohort study.Participants We included 3917 persons, 43 to 86 years of age at the time of a baseline examination in 1988 through 1990 and with information collected in follow-up in 1993 through 1995, and/or 1998 through 2000, and/or 2003 through 2005.Methods Grading of stereoscopic fundus photographs using the Wisconsin Age-Related Maculopathy Grading System.Main outcome measures Cumulative incidence of drusen type and size, pigmentary abnormalities, geographic atrophy, and exudative AMD accounting for competing risk of death.Results The 15-year cumulative incidence was 14.3% for early AMD (the presence of either soft indistinct drusen or the presence of pigmentary abnormalities together with any type of drusen) and 3.1% for late AMD (presence of exudative AMD or geographic atrophy). There was an increased incidence of AMD lesions with age (P<0.05). Individuals > or = 75 years of age at baseline had significantly (P<0.01) higher 15-year incidences of the following characteristics than people 43 to 54 years of age: larger drusen (125 mum in diameter, 24.1% vs 10.6%), soft indistinct drusen (18.7% vs 6.5%), retinal pigmentary abnormalities (20.2% vs 3.7%), exudative macular degeneration (4.4% vs 0.4%), and pure geographic atrophy (3.2% vs 0%). Controlling for age, compared with those with small numbers of only small hard drusen (1-2), those with large numbers of only hard drusen (> or =8) had an increased 15-year age-adjusted incidence of both soft indistinct drusen (16.3% vs 4.7%) and pigmentary abnormalities (10.6% vs 2.7%). Eyes with soft indistinct drusen or pigmentary abnormalities at baseline were more likely to develop late AMD at follow-up than eyes without these lesions (17.8% vs 1.2% and 12.9% vs 1.7%, respectively).Conclusions We document the long-term incidence of signs of AMD and a continuum from small hard drusen to late AMD in older persons in the population. The 15-year cumulative incidence of late AMD in people > or = 75 years of age (8%) indicates a public health problem of significant proportions because the United States population this age is expected to increase by 54% between 2005 and 2025.

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  • The incidence of early AMD, large drusen and pigmentary changes in intermediate AMD, and choroidal neovascularization and geographic atrophy in advanced AMD increase with advancing age.

    “The incidence of early AMD, large drusen and pigmentary changes in intermediate AMD, and choroidal neovascularization (CNV) and GA in advanced AMD increase with advancing age (51, 93).”

    From Unraveling a Multifactorial Late-Onset Disease: From Genetic Susceptibility to Disease Mechanisms for Age-Related Macular Degeneration (2009) · cites this paper as [93]

  • The 15-year incidence of neovascular macular degeneration in the Beaver Dam Eye Study ranged from 0.4% in individuals under 55 years of age to 4.4% in those older than 75 years; the 15-year incidence of soft indistinct drusen ranged from 4.7% to 16.3% in the same age-groups.

    “The 15-year incidence of neovascular macular degeneration in the Beaver Dam Eye Study ranged from 0·4% in individuals under 55 years of age to 4·4% in those older than 75 years; the 15-year incidence of soft indistinct drusen ranged from 4·7% to 16·3% in the same age-groups.19”

    From Age-related macular degeneration (2008) · cites this paper as [19]

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Authors
Klein, R., Klein, B. E. K., Knudtson, M. D., Meuer, S. M., Swift, M., & Gangnon, R. E.
Affiliations
University of Wisconsin–Madison (US)
ORCID
Venue
Ophthalmology
Publisher
Elsevier BV
Published
2007-02
Volume
114
Issue
2
Pages
253-262
ISSN
0161-6420 (ISSN-L)
DOI
10.1016/j.ophtha.2006.10.040
OpenAlex
W200886222
Cited by
638
References
66
Citations by year
2026: 13 · 2025: 22 · 2024: 30 · 2023: 19 · 2022: 26 · 2021: 35 · 2020: 40 · 2019: 30 · 2018: 35 · 2017: 36 · 2016: 45 · 2015: 37 · 2014: 45 · 2013: 54 · 2012: 35
FWCI
33.08
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Ophthalmology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Research to Prevent Blindness
  • National Institutes of Health (EY06594)
Topics
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords
age-related macular degeneration, cumulative incidence, drusen, geographic atrophy, neovascular age-related macular degeneration, age-related risk factors, competing risk of death, population-based cohort
MeSH terms
Adult, Aged, Aged, 80 and over, Aging, Female, Follow-Up Studies, Humans, Macular Degeneration, Male, Middle Aged, Pigment Epithelium of Eye, Risk Factors, Wisconsin, Cohort Studies, Retinal Drusen, Incidence, Age Distribution, Disease Progression

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