1Aravind Eye Hospital Pondicherry, Aravind Eye Care, Pondicherry, India
2Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
3Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
4Dipartimento di Scienze Otorino-Odonto-Oftalmologiche e Cervico Facciali, Sezione di Oftalmologia, Universita` degli Studi di Parma, Parma, Italy
5Ophthalmology and Vision Science, Queen's University Belfast, Belfast, United Kingdom
Commercial Relationships: T. Krishnan, None; R.D. Ravindran, None; G.V.S. Murthy, None; P. Vashist, None; K.E. Fitzpatrick, None; N. John, None; G. Maraini, None; M. Camparini, None; U. Chakravarthy, None; A.E. Fletcher, None.
Support: Wellcome Trust Grant G 073300
Purpose:To describe the prevalence of early and late Age-Related Macular Degeneration (AMD) in older people in India.
Methods:People aged 60 years and older identified using random cluster-sampling in 2 study centres in south and north India, attended an eye examination. Digital fundus images were graded at a single reading centre according to the International Classification System and were stratified into 5 exclusive stages.
Results:2821 people (79% response rate) in north India and 3079 (78%) in south India attended an eye examination. 27% of participants with photographs could not be graded, mainly due to dense opacities, and are included in the denominator of prevalence estimates. The prevalence of late AMD was 0.9% (95% CI 0.7-1.1) and similar in the two centres (p=0.452), comprising mainly of neovascular AMD (44 of 53 cases). For early AMD, the prevalence of stage 1 (soft distinct drusen or pigmentary irregularities) was 28.8% (95% CI 27.0-30.6) with no difference seen between the centres (p=0.113). Differences were observed for stage 2 (soft distinct drusen with pigmentary irregularities or soft indistinct or reticular drusen), 3.8% (95% CI 2.7-5.0) in north India and 6.0% (95% CI 5.2-6.7) in South India, and for stage 3 (soft indistinct or reticular drusen with pigmentary irregularities), 0.04% (95% CI 0-0.1) in north India and 0.3% (95% CI 0.1-0.6) in south India.
Conclusions:The prevalence of early AMD (stages 1 and 2) is similar to that observed in western populations but stage 3 and late AMD prevalence appear to be lower. These estimates however are conservative because of the high proportion of ungradeables.
Keywords: age-related macular degeneration clinical (human) or epidemiologic studies: prevalence/incidence
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