Age related macular degeneration (AMD) is a leading cause of blindness in the United States. About 90% of severe visual loss caused by AMD is due to the neovascular/exudative (N/E) form of the disease. Because treatment is available for certain patients with N/E AMD, it is important to identify and follow closely persons at high risk who can be diagnosed at an early stage of the disease when treatment is most effective. This study aims to determine risk factors for the development of N/E, as well as for atrophic (non-exudative) macular degeneration. Previous studies have suggested associations of N/E and/or atrophic AMD with factors such as systemic hypertension, cardiovascular disease, and nutritional factors, but the evidence is inconclusive. The proposed study will 1) evaluate the hypothesis that systemic hypertension and cardiovascular disease are related to an increased risk of N/E and/or atrophic AMD, 2) evaluate the contribution of nutritional status (e.g., Vitamins E, A, C, selenium, and carotene) to the risk of developing N/E and/or atrophic AMD, and 3) evaluate the contribution of various other factors to the risk of developing N/E or atropic AMD and determine whether these factors differ among individuals with N/E and atrophic disease. The variables to be studied include iris, fundus, and skin pigmentation, refractive error, family history of AMD, light exposure, occupational exposures, and cigarette smoking. This information will be obtained by a case-control study consisting of ophthalmologic patients aged 50-74 years, to be divided into three groups of similar age and sex consisting of 300 patients each: Group I, newly diagnosed patients with definite drusen and pigment epithelial detachments or choroidal neovascular membranes; Group II, newly diagnosed patients with definite drusen and pigmentary disturbance, and Group III, control patients without evidence of macular disease. All patients will be interviewed and have blood pressure, visual acuity, and refractive error measured, fundus and iris photographs taken, and blood drawn for determination of cholesterol, triglycerides, HDL, LDL, and Vitamins E, A, C, selenium, and carotene. Information on past medical, occupational, dietary, and family history, as well as other factors, will be obtained by patient interview. Medical histories will be validated by the treating physician; family histories will be validated by contacting family members and their eye examiners. Estimates of the risks involved will be obtained from comparisons of the case groups and controls.
| Hyman, L; Schachat, A P; He, Q et al. (2000) Hypertension, cardiovascular disease, and age-related macular degeneration. Age-Related Macular Degeneration Risk Factors Study Group. Arch Ophthalmol 118:351-8 |
| Oden, N L (1991) Estimating kappa from binocular data. Stat Med 10:1303-11 |
