Although age-related macular degeneration (AMD) in the leading cause of irreversible blindness in the United States in adults over 50 years of age, very little is known concerning risk factors for progressive visual loss from this disease. This proposal would be the first study to evaluate risk factors for the development and progression of AMD, using both a prospective and cross-sectional study design in a population of men and women enrolled in the Baltimore Longitudinal Study of Aging.
Specific aims are to assess the relationship of the incidence and prevalence of specific macular changes to the following factors: 1) elastotic changes diagnosed in skin biopsies, 2) elevated systolic and/or diastolic blood pressure, 3) smoking history, 4) levels of antitoxidants such as Vitamin E, 5) cardiovascular disease, 6) forced expiratory volume, and 7) iris color. Data on these risk factors, except the first and last, have been collected longitudinally in two-year cycles since 1958 on a total of 780 men and women aged 40 and older. Data collected at each cycle include: skin biopsies, a history of hypertension and use of medication, blood pressures, detailed interview data on smoking history, a seven-day diet diary, history of cardiovascular disease, resting and stress test ECG, and spirometry. Ten years ago, a series of stereo fundus photographs of the macular of 241 participants aged 40 and over were taken. This study would propose to re-photograph the fundi of te 241 participants and photograph the fundi of the remaining 539 participants. The photographs will be graded using a standardized and reproducible technique for the presence of AMD and specifically drusen characteristics associated with an increased risk of developing exudative disease. For the longitudinal component of the study, analyses will compare rates of development of macular changes associated with the factor of interest. The use of regression procedures which consider time- dependent covariates, can be used to control for the simultaneous effect of several factors. Analyses in the cross-sectional component would compare differences in the prevalence of AMD and high-risk drusen in each age-specific exposure group. The goal of the study will be to identify factors associated with the development and progression of AMD which would permit the identification of those patients at increased risk of developing exudative disease, as well as to identify factors that could be utilized in the prevention and/or treatment of this disease.
| West, S; Vitale, S; Hallfrisch, J et al. (1994) Are antioxidants or supplements protective for age-related macular degeneration? Arch Ophthalmol 112:222-7 |
| Vitale, S; West, S; Hallfrisch, J et al. (1993) Plasma antioxidants and risk of cortical and nuclear cataract. Epidemiology 4:195-203 |
| West, S K; Munoz, B; Wang, F et al. (1993) Measuring progression of lens opacities for longitudinal studies. Curr Eye Res 12:123-32 |
| McLeod, S D; West, S K; Quigley, H A et al. (1990) A longitudinal study of the relationship between intraocular and blood pressures. Invest Ophthalmol Vis Sci 31:2361-6 |
| Bochow, T W; West, S K; Azar, A et al. (1989) Ultraviolet light exposure and risk of posterior subcapsular cataracts. Arch Ophthalmol 107:369-72 |
| West, S K; Rosenthal, F S; Bressler, N M et al. (1989) Exposure to sunlight and other risk factors for age-related macular degeneration. Arch Ophthalmol 107:875-9 |
| West, S; Munoz, B; Emmett, E A et al. (1989) Cigarette smoking and risk of nuclear cataracts. Arch Ophthalmol 107:1166-9 |
