Factors Associated With Retinal Vessel Diameters in an Elderly Population: the Thessaloniki Eye Study

Purpose: To identify the factors associated with retinal vessel diameters in the population of the Thessaloniki Eye Study. Methods: Cross-sectional population-based study (age ≥ 60 years). Subjects with glaucoma, late age-related macular degeneration, and diabetic retinopathy were excluded from the analyses. Retinal vessel diameters were measured using the IVAN software, and measurements were summarized to central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and arteriole to venule ratio (AVR). Results: The analysis included 1614 subjects. The hypertensive group showed lower values of CRAE (P = 0.033) and AVR (P = 0.0351) compared to the normal blood pressure (BP) group. On the contrary, the group having normal BP under antihypertensive treatment did not have different values compared to the normal BP group. Diastolic BP (per mm Hg) was negatively associated with CRAE (P < 0.0001) and AVR (P < 0.0001), while systolic BP (per mm Hg) was positively associated with CRAE (P = 0.001) and AVR (P = 0.0096). Other factors significantly associated included age, sex, alcohol, smoking, cardiovascular disease history, ophthalmic medication, weight, and IOP; differences were observed in a stratified analysis based on BP medication use. Conclusions: Our study confirms previous reports about the association of age and BP with vessel diameters. The negative correlation between BP and CRAE seems to be guided by the effect of diastolic BP as higher systolic BP is independently associated with higher values of CRAE. The association of BP status with retinal vessel diameters is determined by diastolic BP status in our population. Multiple other factors are also independently associated with retinal vessel diameters

Prevalence of Age-Related Macular Degeneration in Europe: The Past and the Future.

PURPOSE: Age-related macular degeneration (AMD) is a frequent, complex disorder in elderly of European ancestry. Risk profiles and treatment options have changed considerably over the years, which may have affected disease prevalence and outcome. We determined the prevalence of early and late AMD in Europe from 1990 to 2013 using the European Eye Epidemiology (E3) consortium, and made projections for the future. DESIGN: Meta-analysis of prevalence data. PARTICIPANTS: A total of 42 080 individuals 40 years of age and older participating in 14 population-based cohorts from 10 countries in Europe. METHODS: AMD was diagnosed based on fundus photographs using the Rotterdam Classification. Prevalence of early and late AMD was calculated using random-effects meta-analysis stratified for age, birth cohort, gender, geographic region, and time period of the study. Best-corrected visual acuity (BCVA) was compared between late AMD subtypes; geographic atrophy (GA) and choroidal neovascularization (CNV). MAIN OUTCOME MEASURES: Prevalence of early and late AMD, BCVA, and number of AMD cases. RESULTS: Prevalence of early AMD increased from 3.5% (95% confidence interval [CI] 2.1%-5.0%) in those aged 55-59 years to 17.6% (95% CI 13.6%-21.5%) in those aged ≥85 years; for late AMD these figures were 0.1% (95% CI 0.04%-0.3%) and 9.8% (95% CI 6.3%-13.3%), respectively. We observed a decreasing prevalence of late AMD after 2006, which became most prominent after age 70. Prevalences were similar for gender across all age groups except for late AMD in the oldest age category, and a trend was found showing a higher prevalence of CNV in Northern Europe. After 2006, fewer eyes and fewer ≥80-year-old subjects with CNV were visually impaired (P = 0.016). Projections of AMD showed an almost doubling of affected persons despite a decreasing prevalence. By 2040, the number of individuals in Europe with early AMD will range between 14.9 and 21.5 million, and for late AMD between 3.9 and 4.8 million. CONCLUSION: We observed a decreasing prevalence of AMD and an improvement in visual acuity in CNV occuring over the past 2 decades in Europe. Healthier lifestyles and implementation of anti-vascular endothelial growth factor treatment are the most likely explanations. Nevertheless, the numbers of affected subjects will increase considerably in the next 2 decades. AMD continues to remain a significant public health problem among Europeans

Prevalence of refractive error in Europe: the European Eye Epidemiology (E3) Consortium

To estimate the prevalence of refractive error in adults across Europe. Refractive data (mean spherical equivalent) collected between 1990 and 2013 from fifteen population-based cohort and cross-sectional studies of the European Eye Epidemiology (E3) Consortium were combined in a random effects meta-analysis stratified by 5-year age intervals and gender. Participants were excluded if they were identified as having had cataract surgery, retinal detachment, refractive surgery or other factors that might influence refraction. Estimates of refractive error prevalence were obtained including the following classifications: myopia ≤−0.75 diopters (D), high myopia ≤−6D, hyperopia ≥1D and astigmatism ≥1D. Meta-analysis of refractive error was performed for 61,946 individuals from fifteen studies with median age ranging from 44 to 81 and minimal ethnic variation (98 % European ancestry). The age-standardised prevalences (using the 2010 European Standard Population, limited to those ≥25 and <90 years old) were: myopia 30.6 % [95 % confidence interval (CI) 30.4–30.9], high myopia 2.7 % (95 % CI 2.69–2.73), hyperopia 25.2 % (95 % CI 25.0–25.4) and astigmatism 23.9 % (95 % CI 23.7–24.1). Age-specific estimates revealed a high prevalence of myopia in younger participants [47.2 % (CI 41.8–52.5) in 25–29 years-olds]. Refractive error affects just over a half of European adults. The greatest burden of refractive error is due to myopia, with high prevalence rates in young adults. Using the 2010 European population estimates, we estimate there are 227.2 million people with myopia across Europe

Increasing Prevalence of Myopia in Europe and the Impact of Education

Purpose To investigate whether myopia is becoming more common across Europe and explore whether increasing education levels, an important environmental risk factor for myopia, might explain any temporal trend. Design Meta-analysis of population-based, cross-sectional studies from the European Eye Epidemiology (E3) Consortium. Participants The E3 Consortium is a collaborative network of epidemiological studies of common eye diseases in adults across Europe. Refractive data were available for 61 946 participants from 15 population-based studies performed between 1990 and 2013; participants had a range of median ages from 44 to 78 years. Methods Noncycloplegic refraction, year of birth, and highest educational level achieved were obtained for all participants. Myopia was defined as a mean spherical equivalent ≤-0.75 diopters. A random-effects meta-analysis of age-specific myopia prevalence was performed, with sequential analyses stratified by year of birth and highest level of educational attainment. Main Outcome Measures Variation in age-specific myopia prevalence for differing years of birth and educational level. Results There was a significant cohort effect for increasing myopia prevalence across more recent birth decades; age-standardized myopia prevalence increased from 17.8% (95% confidence interval [CI], 17.6-18.1) to 23.5% (95% CI, 23.2-23.7) in those born between 1910 and 1939 compared with 1940 and 1979 (P = 0.03). Education was significantly associated with myopia; for those completing primary, secondary, and higher education, the age-standardized prevalences were 25.4% (CI, 25.0-25.8), 29.1% (CI, 28.8-29.5), and 36.6% (CI, 36.1-37.2), respectively. Although more recent birth cohorts were more educated, this did not fully explain the cohort effect. Compared with the reference risk of participants born in the 1920s with only primary education, higher education or being born in the 1960s doubled the myopia prevalence ratio-2.43 (CI, 1.26-4.17) and 2.62 (CI, 1.31-5.00), respectively - whereas individuals born in the 1960s and completing higher education had approximately 4 times the reference risk: a prevalence ratio of 3.76 (CI, 2.21-6.57). Conclusions Myopia is becoming more common in Europe; although education levels have increased and are associated with myopia, higher education seems to be an additive rather than explanatory factor. Increasing levels of myopia carry significant clinical and economic implications, with more people at risk of the sight-threatening complications associated with high myopia

Prevalence of Age-Related Macular Degeneration in Europe: The Past and the Future

Purpose Age-related macular degeneration (AMD) is a frequent, complex disorder in elderly of European ancestry. Risk profiles and treatment options have changed considerably over the years, which may have affected disease prevalence and outcome. We determined the prevalence of early and late AMD in Europe from 1990 to 2013 using the European Eye Epidemiology (E3) consortium, and made projections for the future. Design Meta-analysis of prevalence data. Participants A total of 42 080 individuals 40 years of age and older participating in 14 population-based cohorts from 10 countries in Europe. Methods AMD was diagnosed based on fundus photographs using the Rotterdam Classification. Prevalence of early and late AMD was calculated using random-effects meta-analysis stratified for age, birth cohort, gender, geographic region, and time period of the study. Best-corrected visual acuity (BCVA) was compared between late AMD subtypes; geographic atrophy (GA) and choroidal neovascularization (CNV). Main Outcome Measures Prevalence of early and late AMD, BCVA, and number of AMD cases. Results Prevalence of early AMD increased from 3.5% (95% confidence interval [CI] 2.1%–5.0%) in those aged 55–59 years to 17.6% (95%

Epidemiologic study of age-related macular degeneration in the greek population

The purpose of the present study was to estimate the age and gender-specific prevalence of Age-related Macular Degeneration (exudative AMD and geographic atrophy) in a population-based random sample of subjects 60 years of age or older in Thessaloniki. Also to investigate the association of AMD with risk factors such as: age, gender, smoking and alcohol consumption. Of the 3617 eligible subjects, 2554 (participation rate 71%) completed both an interview and a clinical examination. The prevalence of AMD was 2.5%, the prevalence of exudative AMD (NV) was 1.4% and the prevalence of geographic atrophy (GA) was 1.3%. Bilateral AMD was present in 40% of AMD cases or in 1% of the study population. The prevalence of AMD, NV, GA and bilateral AMD increased with increasing age (P<0.0001), while sex-specific statistically significant differences were not seen. Of all participants with AMD, only 33% reported a previous diagnosis of AMD. Current smokers had a two-fold higher risk for AMD compared to non-smokers, while alcohol consumption was not associated with AMD. In conclusion, the prevalence of AMD in Greece is relatively high, comparable to that in other white populations. A dramatic increase in people over 80 years of age was observed. Despite the deleterious effect of AMD in patients’ vision and quality of life, AMD is highly underdiagnosed in Greece.Σκοπός της επιδημιολογικής αυτής μελέτης είναι η εκτίμηση κατά ηλικία και φύλο του επιπολασμού της Ηλικιακής Εκφύλισης της Ωχράς Κηλίδας (Εξιδρωματικής Ωχροπάθειας και Γεωγραφικής Ατροφίας) σε τυχαίο δείγμα γενικού πληθυσμού, ηλικίας άνω των 60 ετών, κατοίκων του Δήμου Θεσσαλονίκης. Επίσης να μελετηθεί η συσχέτιση της ΗΕΩ με παράγοντες κινδύνου όπως είναι η ηλικία, το φύλο, το κάπνισμα και η κατανάλωση αλκοόλ. Από τα 3617 επιλέξιμα άτομα, 2554 τελικά συμμετείχαν στη μελέτη (ποσοστό συμμετοχής 71%). Η εξέταση περιλάμβανε συνέντευξη με συγκεκριμένο ερωτηματολόγιο και οφθαλμολογική εξέταση με σχισμοειδή λιχνία. Ο επιπολασμός της ΗΕΩ στο σύνολο της μελέτης ήταν 2.5%. Ο επιπολασμός της Εξιδρωματικής Ωχροπάθειας (ΕΩ) ήταν 1.4% και της Γεωγραφικής Ατροφίας (ΓΑ) 1.3%. Αμφοτερόπλευρη ΗΕΩ παρουσιάζονταν στο 40% των περιπτώσεων ή στο 1% του συνολικού πληθυσμού. Η συχνότητα της ΗΕΩ, ΕΩ, ΓΑ και της αμφοτερόπλευρης ΗΕΩ αυξάνονταν με την αύξηση της ηλικίας. Δεν παρατηρήθηκε στατιστικά σημαντική διαφορά ανάμεσα στα δύο φύλα. Από όλους τους συμμετέχοντες με ΗΕΩ μόνο το 33% ανέφερε ότι γνώριζε ότι έπασχε από τη νόσο. Οι ενεργοί καπνιστές είχαν περίπου διπλάσια πιθανότητα να πάσχουν από ΗΕΩ σε σχέση με τους μη καπνιστές, ενώ η κατανάλωση αλκοόλ δεν παρουσίαζε συσχέτιση με την ΗΕΩ. Συμπερασματικά, ο επιπολασμός της ΗΕΩ στην Ελλάδα είναι σχετικά υψηλός, συγκρίσιμος με αυτόν σε άλλους λευκούς πληθυσμούς. Παρατηρήθηκε δραματική αύξηση της συχνότητας της νόσου στα άτομα ηλικίας άνω των 80 χρονών. Παρά την καταστροφική επίδραση της ΗΕΩ στη όραση και την ποιότητα ζωής των ασθενών, η νόσος είναι ιδιαίτερα υποδιαγνωσμένη στην Ελλάδα