To determine the prevalence of age-related macular degeneration (AMD) and examine relationships of retinal drusen, retinal pigmentary abnormalities and early AMD to age, sex and other risk factors in 2810 people 21-84 years of age, participating in the Beaver Dam Offspring Study (BOSS).
The presence and severity of various characteristics of drusen and other lesions typical of AMD were determined by grading digital color fundus images using the Wisconsin Age-Related Maculopathy Grading System.
Early AMD was present in 3.4% of the cohort and varied from 2.4% in those 21-34 years of age to 9.8% in those 65 years of age or older. In a multivariable model (expressed as Odds Ratio [OR]; 95% Confidence Interval [CI]), age (1.22 per 5 years of age; 1.09, 1.36), being male (1.65; 1.01, 2.69), more pack years smoked (1 to 10 vs 0, 1.31; 0.75, 2.29; 11+ vs 0, 1.67; 1.03, 2.73), higher serum HDL cholesterol (per 5 mg/dL 0.91; 0.83, 0.998), and hearing impairment (2.28; 1.41, 3.71) were associated with early AMD. There were no associations of blood pressure level, body mass index, physical activity, history of heavy drinking, white blood cell count, hematocrit, platelet count, serum total cholesterol, or carotid intimal-medial thickness with early AMD.
These data indicate that early AMD is infrequent before age 55 years but increases with age thereafter. Early AMD is related to modifiable risk factors, e.g., smoking and serum HDL cholesterol.