| Abstract |
PURPOSE: To study the relationship between baseline spherical equivalents
(SphE) of refraction and prevalent as well as incident age-related
maculopathy (pARM and iARM, respectively). METHODS: The study was
performed as part of the Rotterdam Study, a population-based, prospective
cohort study. The SphE (in diopters), measured with autorefraction and
subjective optimization, was recorded in 6209 subjects aged 55 years or
more. Aphakic or pseudophakic eyes at baseline were excluded. Stereoscopic
transparencies of the macular region were graded according to the
International Classification and Grading System. ARM was defined as large
soft drusen with pigmentary changes, or indistinct drusen, or atrophic or
neovascular age-related macular degeneration (AMD). For the prevalence
analyses, ARM was classified into no, p(early)ARM, or pAMD, and in each
subject the eye with the most advanced ARM and the corresponding
refraction was selected. After a mean 5.2 years of follow-up, 4935
subjects had complete data for these incidence analyses. In each subject,
the eye with iARM was selected. RESULTS: The age- and gender-adjusted odds
ratio (OR) of pARM (n = 536) for every diopter of progress toward
hyperopia was 1.09 (95% confidence interval [CI]1.04-1.13). For
p(early)ARM (n = 440) the OR was 1.09 (1.04-1.14) and for pAMD (n = 96)
the OR was 1.09 (1.00-1.19). Baseline refraction was significantly
associated with increased risk of iARM (n = 497). For each diopter of
progress toward hyperopia the OR was 1.05 (95% CI 1.01-1.10). Additional
adjustments for smoking, atherosclerosis, and blood pressure did not alter
the relationship. CONCLUSIONS: These population-based incidence data
confirm results from prevalence and case-control studies that there is an
association between hyperopia and ARM. |