Saunier V, et al. - Authors reported the incidence and related risk factors of age-related macular degeneration (AMD) in elderly French individuals. AMD incidence rates were seen to be similar to other European populations. In individuals with high plasma high-density lipoprotein cholesterol levels, a high risk for an incident early AMD was seen. Findings confirm the high risk for progression from early to advanced AMD in heavy smokers and carriers of complement factor H (CFH) Y402H at-risk genotypes.

Methods

• Experts conducted a population-based cohort study of 963 residents of Bordeaux, France, who were 73 years or older at baseline and participated in the Antioxydants, Lipides Essentiels, Nutrition et Maladies Oculaires (ALIENOR) Study between October 2, 2006, and December 21, 2012.
• Out of 829 participants at risk for incident AMD, they observed 659 (79.5%) for a mean (SD) duration of 3.8 (1.1) years.
• Researchers analyzed the data from August 2016 to March 2017.
• They graded the age-related macular degeneration from retinal photographs and spectral-domain optical coherence tomography into 5 exclusive stages: No AMD, early AMD1, early AMD2, late atrophic AMD, and late neovascular AMD.

Results

• Results suggested that among 659 eligible participants, 413 (62.7%) were women, and the mean (SD; range) age was 79.7 (4.4; 73-94) years.
• As per data, a total of 120 incident cases of early AMD and 45 incident cases of advanced AMD were recorded.
• Findings demonstrated the incidence rates of early and advanced AMD to be 79.9 (95% CI, 66.8-95.5) per 1000 person-years and 18.6 (95% CI, 13.9-24.9) per 1000 person-years, respectively, corresponding to 5-year risks of 32.9% and 8.9%.
• In eyes without any AMD at baseline, incidence of advanced AMD per 1000 eye-years was 1.5, it was 42.4 in those with early AMD1, and 85.1 in those with early AMD2.
• According to the results, in multivariate analysis without correction for multiple testing, progression from early to advanced AMD was seen to be related to AMD grade in the fellow eye (hazard ratio [HR] according to grade, 13.0 [95% CI, 2.8-61.2] to 22.5 [95% CI, 2.6-195.9]), having smoked at least 20 pack-years (calculated as number of smoking years × mean number of cigarettes per day/20; HR, 3.0; 95% CI, 1.4-6.5), and complement factor H (CFH) Y402H genotype (CC genotype: HR, 2.3; 95% CI, 1.0-5.3; TC genotype: HR, 1.5; 95% CI, 0.6-3.7).
• They noted the incidence of early AMD to be related to early AMD in the fellow eye (early AMD1: HR, 2.6; 95% CI, 1.6-4.2; early AMD2: HR, 5.6; 95% CI, 3.3-9.4) and high plasma high-density lipoprotein cholesterol levels (HR, 1.2; 95% CI, 1.0-1.4).