Fifteen-Year Cumulative Incidence of Age-Related Macular Degeneration

Purpose To describe the 15-year cumulative incidence of signs of early and late age-related macular degeneration (AMD). Design Population-based cohort study. Participants We included 3917 persons, 43 to 86 years of age at the time of a baseline examination in 1988 through 1990 and with information collected in follow-up in 1993 through 1995, and/or 1998 through 2000, and/or 2003 through 2005. Methods Grading of stereoscopic fundus photographs using the Wisconsin Age-Related Maculopathy Grading System. Main Outcome Measures Cumulative incidence of drusen type and size, pigmentary abnormalities, geographic atrophy, and exudative AMD accounting for competing risk of death. Results The 15-year cumulative incidence was 14.3% for early AMD (the presence of either soft indistinct drusen or the presence of pigmentary abnormalities together with any type of drusen) and 3.1% for late AMD (presence of exudative AMD or geographic atrophy). There was an increased incidence of AMD lesions with age ( P P Conclusions We document the long-term incidence of signs of AMD and a continuum from small hard drusen to late AMD in older persons in the population. The 15-year cumulative incidence of late AMD in people ≥ 75 years of age (8%) indicates a public health problem of significant proportions because the United States population this age is expected to increase by 54% between 2005 and 2025.