Klein R, Klein B E, Jensen S C, Meuer S M
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison 53705-2397, USA.
Ophthalmology. 1997 Jan;104(1):7-21. doi: 10.1016/s0161-6420(97)30368-6.
The aim of the study was to describe the incidence and progression of retinal drusen, retinal pigmentary abnormalities, and signs of late age-related maculopathy.
A population of 3583 adults (range, 43-86 years of age at baseline) living in Beaver Dam, Wisconsin, was studied during a 5-year period.
Characteristics of drusen and other lesions typical of age-related maculopathy were determined by grading stereoscopic color fundus photographs using the Wisconsin Age-Related Maculopathy Grading System.
There was a statistically significant increased incidence of age-related maculopathy lesions with age (P < 0.05). Individuals 75 years of age or older had a significantly (P < 0.01) higher 5-year incidence of the following characteristics than people 43 to 54 years of age: larger sized drusen (125-249 microm, 17.6% vs. 2.1%; > or = 250 microm, 6.5% vs. 0.2%), soft indistinct drusen (16.3% vs. 1.8%), retinal pigment abnormalities (12.9% vs. 0.9%), exudative macular degeneration (1.8% vs. 0%), and pure geographic atrophy (1.7% vs. 0%). After adjusting for age, the incidence of early age-related maculopathy was 2.2 times (95% confidence interval 1.6, 3.2) as likely in women 75 years of age or older compared with men this age. At follow-up, late age-related macular degeneration was more likely to develop in eyes with soft indistinct drusen (6.5% vs. 0.1%) or retinal pigmentary abnormalities (7.1% vs. 0.1%) at baseline than in eyes without these lesions.
These population-based estimates document the high incidence of signs of age-related maculopathy in people 75 years of age or older, and in women compared with men that age. The findings demonstrate that the presence of soft drusen and pigmentary abnormalities significantly increases the risk for the development of geographic atrophy and exudative macular degeneration.
本研究旨在描述视网膜玻璃膜疣、视网膜色素异常及晚期年龄相关性黄斑病变体征的发生率和进展情况。
对居住在威斯康星州比弗代尔的3583名成年人（基线年龄范围为43 - 86岁）进行了为期5年的研究。
采用威斯康星年龄相关性黄斑病变分级系统，通过对立体彩色眼底照片进行分级，确定玻璃膜疣及其他年龄相关性黄斑病变典型病变的特征。
年龄相关性黄斑病变的发生率随年龄增长有统计学显著升高（P < 0.05）。75岁及以上个体以下特征的5年发生率显著高于43至54岁人群（P < 0.01）：较大尺寸的玻璃膜疣（125 - 249微米，17.6%对2.1%；≥250微米，6.5%对0.2%）、软性边界不清的玻璃膜疣（16.3%对1.8%）、视网膜色素异常（12.9%对0.9%）、渗出性黄斑变性（1.8%对0%）和单纯性地图样萎缩（1.7%对0%）。校正年龄后，75岁及以上女性早期年龄相关性黄斑病变的发生率是同龄男性的2.2倍（95%置信区间1.6, 3.2）。随访时，基线时存在软性边界不清的玻璃膜疣（6.5%对0.1%）或视网膜色素异常（7.1%对0.1%）的眼睛比无这些病变的眼睛更易发生晚期年龄相关性黄斑变性。
这些基于人群的估计数据表明，75岁及以上人群中年龄相关性黄斑病变体征的发生率较高，且女性高于同龄男性。研究结果表明，软性玻璃膜疣和色素异常的存在显著增加了地图样萎缩和渗出性黄斑变性发生的风险。
