Ophthalmology. 2000 Dec;107(12):2224-32. doi: 10.1016/s0161-6420(00)00409-7.
To investigate possible risk factors for age-related macular degeneration (AMD) in participants in the Age-Related Eye Disease Study (AREDS).
Case-control study.
Of the 4757 persons enrolled in AREDS, 4519 persons aged 60 to 80 years were included in this study. The lesions associated with AMD ranged from absent in both eyes to advanced in one eye.
Stereoscopic color fundus photographs of the macula were used to place participants into one of five groups, based on the frequency and severity of lesions associated with AMD. Participants with fewer than 15 small drusen served as the control group.
Staged model building techniques were used to compare each of the four case groups with the control group. Increased age was a consistent finding of all four of the case groups compared with the control group, and all the following associations were age adjusted. Persons with either intermediate drusen, extensive small drusen, or the pigment abnormalities associated with AMD (group 2) were more likely to be female, more likely to have a history of arthritis, and less likely to have a history of angina. Persons with one or more large drusen or extensive intermediate drusen (group 3) were more likely to use hydrochlorothiazide diuretics and more likely to have arthritis. Hypertension, hyperopia, presence of lens opacities, and white race were also found more frequently in this group as well as in persons with neovascular AMD (group 5). Only persons in group 5 were more likely to have an increased body mass index, whereas persons with geographic atrophy (group 4) as well as those in groups 3 and 5 were more likely to have completed fewer years in school or to be smokers. Those with geographic atrophy were also more likely to use thyroid hormones and antacids.
Our findings for smoking and hypertension, which have been noted in previous studies, suggest that two important public health recommendations, the avoidance of smoking and the prevention of hypertension, may reduce the risk of developing AMD. Other associations, such as those for hyperopia, lens opacities, less education, female gender, increased body mass index, and white race, which have been noted in other studies, are also seen in the AREDS population. The increased use of thyroid hormones and antacids in persons with geographic atrophy and the increased likelihood of arthritis or hydrochlorothiazide use in persons with one or more large drusen or extensive intermediate drusen have not been previously reported and need additional investigation.
在年龄相关性眼病研究（AREDS）的参与者中调查年龄相关性黄斑变性（AMD）的可能危险因素。
病例对照研究。
在AREDS登记的4757人中，本研究纳入了4519名年龄在60至80岁之间的人。与AMD相关的病变范围从双眼无病变到单眼晚期病变。
使用黄斑的立体彩色眼底照片，根据与AMD相关病变的频率和严重程度将参与者分为五组之一。小玻璃膜疣少于15个的参与者作为对照组。
采用分期模型构建技术将四个病例组中的每一组与对照组进行比较。与对照组相比，年龄增加是所有四个病例组的一致发现，并且所有以下关联均进行了年龄调整。患有中度玻璃膜疣、广泛的小玻璃膜疣或与AMD相关的色素异常（第2组）的人更可能为女性，更可能有关节炎病史，而心绞痛病史的可能性较小。有一个或多个大玻璃膜疣或广泛中度玻璃膜疣（第3组）的人更可能使用氢氯噻嗪利尿剂，并且更可能患有关节炎。高血压、远视、晶状体混浊和白种人在该组以及新生血管性AMD患者（第5组）中也更常见。只有第5组的人更可能体重指数增加，而患有地图状萎缩的人（第4组）以及第3组和第5组的人更可能受教育年限较少或为吸烟者。患有地图状萎缩的人也更可能使用甲状腺激素和抗酸剂。
我们关于吸烟和高血压的研究结果与先前研究一致，表明两项重要的公共卫生建议，即避免吸烟和预防高血压，可能会降低患AMD的风险。其他关联，如远视、晶状体混浊、受教育程度较低、女性、体重指数增加和白种人，在先前的其他研究中已被提及，在AREDS人群中也可见。地图状萎缩患者中甲状腺激素和抗酸剂使用增加，以及有一个或多个大玻璃膜疣或广泛中度玻璃膜疣的患者患关节炎或使用氢氯噻嗪的可能性增加，此前尚未见报道，需要进一步研究。
