MACULAR DISEASE

Age-related macular degeneration (AMD) constitutes one of the main causes of macular disease in an elderly population, affecting about one in every seven patients examined in a recent French population study, according to Catherine Creuzot- Garcher MD, PhD, FEBO.

“The initial results of this study looking at the prevalence of atrophic and neovascular age-related macular degeneration concurs with the findings of other population-based studies conducted in the literature. Nevertheless, we think that it would be interesting to compare these data, which were derived exclusively from fundus photographs, alongside those taken from optic coherence tomography, to give us a clearer picture of the disease prevalence in this population group,” she told the annual meeting of the French Society of Ophthalmology (SFO).

Prof Creuzot-Garcher, professor of ophthalmology and chair at the University Hospital of Dijon, France, noted that there is a critical need to learn as much as possible about the evolution of macular degeneration in older populations.

“This disease is the primary cause of reduced visual acuity in persons older than 50 in developed countries and is the third overall cause of blindness worldwide. And with populations tending to live longer in developed countries we are likely to see a huge increase in age-related diseases such as macular degeneration in the coming years,” she said.

Prof Creuzot-Garcher explained that the MONTRACHET study (Maculopathy, Optic Nerve, Nutrition, Neurovascular and heart diseases) was part of a wider population study of 9,000 patients older than 65 that began in 1999 in the French cities of Bordeaux, Dijon and Montpellier.

After 10 years of follow-up, the Dijon patient cohort also underwent a complete ophthalmological examination that included systematic colour fundus photographs of all patients.

The fundus images were analysed by two trained technicians and an ophthalmologist, and the prevalence of macular degeneration was classified according to objective criteria including number and size of drusen, presence of geographic atrophy and/or macular degeneration based on the AREDS study classification.

The preliminary analysis included a total of 1,035 patients - 385 male and 650 female - with a mean age of 82.2 years (± 3.8), were included in the study. After analysis of the fundus photographs, 937 patients whose images were deemed to be of sufficient quality to enable interpretation were included in the final analysis.

AMD prevalence        
The prevalence of AMD was 4.2 per cent which was comparable to ALIENOR or the EUREYE studies, noted Prof Creuzot-Garcher.

Summing up, Prof Creuzot-Garcher said that population-based studies were extremely valuable in trying to learn more about possible risk factors for age-related pathologies such as macular degeneration.

“These are preliminary studies but they do give us valuable new data on the prevalence of macular degeneration and age-related maculopathy in a French population. We need more research to explore possible links between AMD and environmental factors, as well as neurological diseases linked to age and cardiovascular diseases,” she said.