Risk factors for age related macular degeneration - Pooled findings from three continents

Objective: To assess the prevalence and potential risk factors for late age -related macular degeneration (AMD) in three racially similar populations f rom North America, Europe, and Australia, Design: Combined analysis of population-based eye disease prevalence data. Participants: There were 14,752 participants with gradable photographs from the Beaver Dam Eye Study (n = 4756), Rotterdam Study (n = 6411), and Blue Mountains Eye Study (n = 3585). Main Outcome Measures: AMD diagnosis was made from masked grading of stereo macular photographs. Final classification of AMD cases was agreed by conse nsus between study investigators. Results: AMD prevalence was strongly age related. Overall, AMD was present in 0.2% of the combined population aged 55 to 64 years, rising to 13% of th e population older than 85 years. Prevalence of neovascular AMD (NV) increa sed from 0.17% among subjects aged 55 to 64 years to 5.8% for those older t han 85 years, Prevalence of pure geographic atrophy (GA) increased from 0.0 4% to 4.2% for these age groups. There were no significant gender differenc es in the prevalence of NV or GA. Subjects in the Rotterdam population had a significantly lower age-adjusted and smoking-adjusted risk of NV than sub jects in the Beaver Dam and Blue Mountains populations. Apart from age, tob acco smoking was the only risk factor consistently associated with any form of AMD in all sites separately and in pooled analyses over the three sites . Conclusions: These combined data from racially similar communities across t hree continents provide strong and consistent evidence that tobacco smoking is the principal known preventable exposure associated with any form of AM D. (C) 2001 by the American Academy of Ophthalmology.