The purpose of this epidemiologic study is to evaluate the association of markers of generalized atherosclerosis with the incidence of early and late stage age-related maculopathy in a population-based, nested incident case-control study. This proposal builds on the population-based studies of aging in Beaver Dam, WI: The Beaver Dam Eye Study (EY06594) and the Epidemiology of Hearing Loss Study (AG11099). Participants with incident early age-related maculopathy or incident late-stage age-related maculopathy as determined from grading of standardized photographs taken at two examinations five years apart will be eligible as cases for this study. Participants without age-related maculopathy at the time of the 1 0-yr follow-up eye examination will be eligible as controls. Incident early cases will be frequency-matched by age and gender to controls using a two-to-one ratio of controls to cases. Incident late age-related maculopathy cases will be frequency-matched to controls by age and gender using a three-to-one ratio of controls to cases. Based on expected 5-yr incidence rates and participation rates in both studies, we estimate that a total of 189 cases with incident early age-related maculopathy and 378 controls and 34 cases with incident late age-related maculopathy and 102 controls will be included in this study. Generalized atherosclerosis will be measured by intima-medial thickness and the presence of plaque in the carotid arteries. Stored videotapes of B mode ultrasound scans of the carotid arteries were obtained as of the Epidemiology of Hearing Loss Study, using a modification of the Atherosclerosis Risk in Communities Study protocol. These scans will be read, and measurements of the intima-medial thickness made, using the Atherosclerosis Risk in Communities ultrasound reading protocol. Age-related maculopathy is well-recognized to be the leading cause of blindness among older adults and a significant public health problem for older adults. As yet there is no way to prevent or effectively treat this disorder. This study will provide important epidemiologic information about the role of atherosclerosis in the etiology of age-related maculopathy. It takes advantage of an unique opportunity to evaluate this association by utilizing an existing population-based cohort with standardized assessments of the incidence of age-related maculopathy and standardized carotid artery ultrasound scans.
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