Ikram M Kamran, van Leeuwen Redmer, Vingerling Johannes R, Hofman Albert, de Jong Paulus T V M
Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
Invest Ophthalmol Vis Sci. 2003 Sep;44(9):3778-82. doi: 10.1167/iovs.03-0120.
To study the relationship between baseline spherical equivalents (SphE) of refraction and prevalent as well as incident age-related maculopathy (pARM and iARM, respectively).
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.
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.
These population-based incidence data confirm results from prevalence and case-control studies that there is an association between hyperopia and ARM.
研究屈光不正的基线球镜当量（SphE）与年龄相关性黄斑病变的患病率及发病率（分别为pARM和iARM）之间的关系。
本研究作为鹿特丹研究的一部分进行，这是一项基于人群的前瞻性队列研究。使用自动验光和主观验光优化测量的SphE（以屈光度为单位）记录于6209名55岁及以上的受试者中。排除基线时无晶状体或人工晶状体眼。黄斑区的立体透明片根据国际分类和分级系统进行分级。ARM定义为伴有色素改变的大的软性玻璃膜疣、或不明确的玻璃膜疣、或萎缩性或新生血管性年龄相关性黄斑变性（AMD）。在患病率分析中，ARM分为无、p（早期）ARM或pAMD，在每个受试者中，选择具有最严重ARM的眼睛及其相应的屈光不正情况。经过平均5.2年的随访，4935名受试者有这些发病率分析的完整数据。在每个受试者中，选择患有iARM的眼睛。
每增加1个屈光度的远视进展，pARM（n = 536）的年龄和性别调整优势比（OR）为1.09（95%置信区间[CI]1.04 - 1.13）。对于p（早期）ARM（n = 440），OR为1.09（1.04 - 1.14），对于pAMD（n = 96），OR为1.09（1.00 - 1.19）。基线屈光不正与iARM（n = 497）风险增加显著相关。每增加1个屈光度的远视进展，OR为1.05（95% CI 1.01 - 1.10）。对吸烟、动脉粥样硬化和血压进行额外调整后，这种关系未改变。
这些基于人群的发病率数据证实了患病率和病例对照研究的结果，即远视与ARM之间存在关联。
