Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Ophthalmology. 2012 Dec;119(12):2519-25. doi: 10.1016/j.ophtha.2012.06.043. Epub 2012 Aug 24.
To examine the incidence of age-related macular degeneration (AMD) and its associated factors in an adult Chinese population.
Population-based study.
The Beijing Eye Study, which included 4439 subjects (age ≥ 40 years) in 2001, was repeated in 2006 with 3251 (73.2%) subjects participating.
Fundus photographs were graded using the International Age-related Maculopathy Epidemiological Study Group grading system.
Incidence of AMD.
Gradable slides were available on 3049 (93.9%) subjects who participated in the survey of 2001 and again in 2006. The incidence of early, late, and neovascular AMD per eye was 2.6% (95% confidence interval [CI], 2.2-3.0), 0.1% (95% CI, 0.00-0.2), and 0.1% (95% CI, 0.00-0.2), respectively. The incidence of early, late, and neovascular AMD per person was 4.2 ± 0.4% (95% CI, 3.5-5.0), 0.1 ± 0.1% (95% CI, 0.0-0.2), and 0.1 ± 0.1% (95% CI, 0.0-0.2), respectively. By multivariate analysis, incident early AMD was associated significantly with greater age at baseline (P = 0.01; odds ratio [OR], 1.03; 95% CI, 1.01-1.06), smaller optic disc size (P = 0.007; OR, 0.50; 95% CI, 0.30-0.83), smaller scleral spur distance (P = 0.04; OR, 0.59; 95% CI, 0.36-0.98), and hyperopic refractive error (P = 0.057; OR, 1.15; 95% CI, 1.00-1.33), with the latter being significant only marginally. It was not associated with the systemic parameters of gender, body height, body mass index, region of habitation, level of education, profession, smoking, arterial blood pressure, diabetes mellitus, fasting blood concentrations of glucose, triglycerides, high-density or low-density lipoproteins; or the ocular parameters of intraocular pressure, retinal arterial and vein diameters, retinal microvascular abnormalities, amount of nuclear cataract, cortical cataract or subcapsular cataract, pseudophakia, glaucoma, nonglaucomatous optic neuropathy, retinal vein occlusions, size of the beta zone of parapapillary atrophy, or progression of the zone of atrophy during the follow-up from 2001 to 2006.
Hyperopia, short interscleral spur distance, and small optic disc size were, beside older age, the main factors associated with incident early AMD. This may point to a small globe size, potentially in relation to a firmly attached vitreous, playing a role in early incident AMD.
FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any of the materials discussed in this article.
在成年中国人中调查年龄相关性黄斑变性（AMD）的发病率及其相关因素。
基于人群的研究。
北京眼研究于 2001 年纳入 4439 名（年龄≥40 岁）受试者，2006 年再次调查时 3251 名（73.2%）受试者参与。
使用国际年龄相关性眼病研究组分级系统对眼底照片进行分级。
AMD 的发病率。
在 2001 年和 2006 年两次调查中均参与的 3049 名（93.9%）受试者有可分级的眼底照片。每只眼早期、晚期和新生血管性 AMD 的发病率分别为 2.6%（95%置信区间[CI]，2.2-3.0）、0.1%（95%CI，0.00-0.2）和 0.1%（95%CI，0.00-0.2）。每人早期、晚期和新生血管性 AMD 的发病率分别为 4.2±0.4%（95%CI，3.5-5.0）、0.1±0.1%（95%CI，0.0-0.2）和 0.1±0.1%（95%CI，0.0-0.2）。多变量分析显示，新发早期 AMD 与基线时年龄较大（P=0.01；优势比[OR]，1.03；95%CI，1.01-1.06）、视盘较小（P=0.007；OR，0.50；95%CI，0.30-0.83）、巩膜嵴距离较小（P=0.04；OR，0.59；95%CI，0.36-0.98）和远视屈光不正（P=0.057；OR，1.15；95%CI，1.00-1.33）显著相关，后者仅呈边缘显著。它与性别、身高、体重指数、居住地区、教育水平、职业、吸烟、动脉血压、糖尿病、空腹血糖、甘油三酯、高密度或低密度脂蛋白等全身参数；或眼内压、视网膜动脉和静脉直径、视网膜微血管异常、核白内障量、皮质白内障或囊下白内障、白内障术后、青光眼、非青光眼性视神经病变、视网膜静脉阻塞、视乳头旁β区大小、或 2001 年至 2006 年随访期间萎缩区进展等眼部参数均无相关性。
远视、短巩膜嵴距离和小视盘大小除年龄外，是与新发早期 AMD 相关的主要因素。这可能表明眼球较小，可能与牢固附着的玻璃体有关，在早期 AMD 发病中起作用。
作者无本文讨论的任何材料的专有或商业利益。
