Klein R, Cruickshanks K J, Klein B E, Nondahl D M, Wiley T
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison 53705-2397, USA.
Arch Ophthalmol. 1998 Mar;116(3):360-5. doi: 10.1001/archopht.116.3.360.
To describe the relationship of age-related maculopathy (ARM) to hearing loss.
Population-based cohort study.
All 3397 adults (age range, 48-92 years) living in Beaver Dam, Wis, who were examined for age-related eye disease and hearing loss from March 1, 1993, to July 18, 1995, and who had analyzable hearing thresholds in at least 1 ear and fundus photographs gradable for ARM in at least 1 eye.
Characteristics of drusen and other lesions typical of ARM were determined by grading stereoscopic color fundus photographs using the Wisconsin Age-Related Maculopathy Grading System. We used standard protocols of pure-tone air-conduction audiometry to assess hearing loss, which was defined as the pure-tone average of hearing thresholds at 500, 1000, 2000, and 4000 Hz greater than 25-dB hearing level.
The prevalence of ARM was 25.4% and of hearing loss was 45.0% in this population. Both conditions were present in 15.1%. The relationships between early ARM lesions and hearing loss were not statistically significant. After controlling for age and sex, persons with late ARM were more likely (odds ratio, 3.15; 95% confidence interval, 1.34-7.42) to have hearing loss than persons without late ARM. This relation did not change when other factors related to ARM or hearing loss (eg, cigarette smoking status, history of occupational noise exposure, and history of cardiovascular disease) were entered into multivariate models.
These population-based estimates document the frequent coexistence of signs of ARM and hearing loss. As late ARM is an important cause of loss of vision, and as hearing loss is associated with difficulty in communicating, the high frequencies of sensory comorbidity may affect maintenance of independent functioning as people age. Further study is necessary to examine why late ARM and hearing loss are associated.
描述年龄相关性黄斑病变（ARM）与听力损失之间的关系。
基于人群的队列研究。
居住在威斯康星州比弗代尔的所有3397名成年人（年龄范围48 - 92岁），他们在1993年3月1日至1995年7月18日期间接受了年龄相关性眼病和听力损失检查，且至少一只耳朵有可分析的听力阈值，至少一只眼睛有可用于ARM分级的眼底照片。
使用威斯康星年龄相关性黄斑病变分级系统对立体彩色眼底照片进行分级，以确定玻璃膜疣及其他典型ARM病变的特征。我们采用纯音气导听力测定的标准方案来评估听力损失，听力损失定义为500、1000、2000和4000赫兹听力阈值的纯音平均值大于25分贝听力水平。
该人群中ARM的患病率为25.4%，听力损失的患病率为45.0%。两种情况同时存在的比例为15.1%。早期ARM病变与听力损失之间的关系无统计学意义。在控制年龄和性别后，晚期ARM患者比无晚期ARM患者更有可能（优势比，3.15；95%置信区间，1.34 - 7.42）出现听力损失。当将与ARM或听力损失相关的其他因素（如吸烟状况、职业噪声暴露史和心血管疾病史）纳入多变量模型时，这种关系并未改变。
这些基于人群的估计数据证明了ARM体征与听力损失经常同时存在。由于晚期ARM是视力丧失的重要原因，且听力损失与沟通困难相关，随着人们年龄增长，感觉共病的高发生率可能会影响独立功能的维持。有必要进一步研究晚期ARM与听力损失相关的原因。
