This epidemiological study is completed on island Rab, located in North Adriatic Sea. For this study it is important
that Adriatic Sea has one of the highest solar radiations in geographical area of Europe. The aim of this epidemiological
study is to estimate correlation between incidence of Age-Related Macular Degeneration (AMD) and exposure of sunlight
in two different populations on island Rab. In the first group of population of island Rab, agriculturists and fishermen
(n=1300), incidence of AMD was in 18%, but in urban population only 2.5%. It is very interesting that correlation exists
between incidence of AMD and exfoliation syndrome. In the group of chronic exposure to sunlight (agriculturists and
fishermen) exfoliation syndrome exists in 28%, but in urban population it has never been seen. The age in both populations
was 45–65 years. We can conclude that there is a very significant correlation between chronic exposure to sunlight
and appearance of AMD

Božidar Vojniković

Josip Španjol

Miran Čoklo

Sanja Njirić

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Coll. Antropol. 31 (2007) Suppl. 1: 43–44Original scientific paperUltraviolet Sun Radiation and Incidenceof Age-Related Macular Degeneration onCroatian Island RabBo`idar Vojnikovi}1, Sanja Njiri}2, Miran ^oklo3 and Josip [panjol41 Eye Polyclinic »Dr. B. Vojnikovi}«, Rijeka, Croatia2 Eye Polyclinic »Dr. L. Pavi~evi}«, Rijeka, Croatia3 Department of Forensic Medicine, Rijeka University School of Medicine, Rijeka, Croatia4 Department of Urology, Rijeka University Hospital, Rijeka, CroatiaA B S T R A C TThis epidemiological study is completed on island Rab, located in North Adriatic Sea. For this study it is importantthat Adriatic Sea has one of the highest solar radiations in geographical area of Europe. The aim of this epidemiologicalstudy is to estimate correlation between incidence of Age-Related Macular Degeneration (AMD) and exposure of sunlightin two different populations on island Rab. In the first group of population of island Rab, agriculturists and fishermen(n=1300), incidence of AMD was in 18%, but in urban population only 2.5%. It is very interesting that correlation existsbetween incidence of AMD and exfoliation syndrome. In the group of chronic exposure to sunlight (agriculturists andfishermen) exfoliation syndrome exists in 28%, but in urban population it has never been seen. The age in both popula-tions was 45–65 years. We can conclude that there is a very significant correlation between chronic exposure to sunlightand appearance of AMD.Key words: AMD, exfoliation syndrome, exposure to sunlightIntroductionThrough a long period of time it is estimated that en-vironment is very significant risk factor in developmentof Age-Related Macular Degeneration (AMD)1–7. One ofthe most important climate factors in development ofAMD is increase of solar UV-radiation8–10. AMD is todayleading factor of vision loss in the world11,12. Ultravioletlight radiation with very high energy can lead to very se-rious damage, initiate deleterious biochemical reactions,to make photoproduct dimmers, damage nucleic acidsand consequently formed abnormal DNA13,15. Beside in-fluence on development of AMD, solar UV-radiation canalso initiate as a risk factor even in development of ocu-lar melanoma16. Histopathological alterations are mostlyknown in AMD7,17, but the future of solving a problem ofAMD is in the proteomic analysis18,19.The aim of this epidemiological analysis is to estimatethe influence of solar UV radiation as a risk factor in de-velopment of AMD on the island of Rab.Patients and MethodsThe island of Rab is geographically located in North ofthe Adriatic Sea (44°40’ N), with very high solar radia-tion. All patients (n=1371) were divided in two groups:population of agriculturists and fishermen (n=1300) andurban population (n=71). Their age was between 45 and65 years. All patients were examined in mydriasis withslit lamp-biomicroscopy, exe pressure and fundus pic-ture. This epidemiologic study is completed between theyears 2003 and 2005. Each patient was taken a very seri-ous anamnesis and style of life questions.Results and ConclusionIn table 1, incidence of AMD is presented in two dis-tinct groups: in the first group of agriculturists and fish-ermen population AMD is present in 18%, but in urbanpopulation in only 2.5% (2 patients only). Correlation be-43Received for publication October 1, 2006U:\coll-antropolo\coll-antro-suppl-1-2007\vojnikovic 4.vp9. veljaŁa 2007 12:46:48Color profile: DisabledComposite  150 lpi at 45 degreestween the appearance of AMD and exfoliation syndromeis very significant, 28% in the first group of agriculturistsand fishermen population.In this epidemiological study, it can be concluded thatthe appearance of AMD is significantly in correlationwith chronic exposure to sunlight UV-radiation.R E F E R E N C E S1. HAM WT Jr, MUELLER HA, RUFFOB JJ Jr, Am J Ophtalmol, 93(1982) 299. — 2. LERMAN S: Radiant energy and the eye. (MacMillan,New York, 1980). — 3. LUECKE A, REME CH, Klin Monatbl Augenhelik,184 (1984) 77. — 4. PEYMAN GA, ZAK R, J Am Intraocular Impl Soc, 9(1983) 161. — 5. SYKES SM, ROBINSON WG JR, WAXLER M, KUWA-BARA T, Investigat Ophtalmol Visual Sci, 20 (1981) 425. — 6. TSO MOM,WOODFORD BJ, Ophtalmology, 90 (1983) 952. — 7. VOJNIKOVI] B:Einsteinov zakon elementarne fotokemijske reakcije. (Veleu~ili{te VelikaGorica, Zagreb, 2005.). — 8. PENZAR B, PENZAR I, ORLI] M: Vrijeme iklima hrvatskog Jadrana (»Dr. Feletar«, Koprivnica, 2001). — 9. KANCRP, Int J Climat, 18 (1998) 457. — 10. LISAC I, Gospodarstvo i okoli{, 33(1998) 381 — 11. MUKESH BN, DIMITROV PN, LEIKIN S, WANG JJ,MITCHELL P, MCCARTY CA, TAYLOR HR, Ophtalmology, 111 (2004)1176. — 12. TAYLOR HR, KEEFFE JE, VU HT, WANG JJ, ROCHTCHI-NA E, PEZZULLO ML, MITCHELL P, Med J Aust, 182 (2005) 565. — 13.RODNEY B: Concepts in Biochemistry (JohnWiley & Sons, Inc., Toronto,2002). — 14. BRUMEN V, GARAJ-VRHOVAC V, Sigurnost, 45 (2003) 107.— 15. HECK DE, GERECKE DR, VETIRANO AM, LASKIN JD, Toxicol-ogy and Applied Pharmacology, 195 (2004) 288. — 16. VAJDIC CM, KRI-CKER A, GIBLIN M, MCKENZIE J, AITKEN J, GILES GG, ARM-STRONG BK, Int J Cancer, 101 (2002) 175. — 17. MYRON Y, BEN SF:Ocular Pathology (JBLippincott Company, Philadelphia, 1989). — 18.ETHEN CM, REILLY C, FENG X, TIMOTHY WO, FERRINGTON DA,Source Invest OphtalmolVisual Sci, 47 (2006) 2280. — 19. NORDGAARDCL, BERG KM, KAPPHAHN R, REILLY C, FENG X, OLSEN TW, FER-RINGTON A, Source Invest Ophtalmol Visual Sci, 47 (2006) 815.B. Vojnikovi}Eye Polyclinic »Dr. B. Vojnikovi}«, Antuna Barca 3B, 51000 Rijeka, Croatiae-mail: decv@decv.comULTRAVIOLETNO SUN^EVO ZRA^ENJE I U^ESTALOST POJAVE SENILNE MAKULARNEDEGENERACIJE U POPULACIJI PU^ANSTVA OTOKA RABAS A @ E T A KU vremenskom periodu od 2003–2005. godine pregledana je 1371 osoba na otoku Rabu. Populacija je podijeljena udvije skupine: poljoprivrednici i ribari (1300 osoba) i u drugoj skupini urbano stanovni{tvo (71 osoba). U prvoj skupinipregledom fundusa dijagnosticirana je u 18% AMD, po~etnog i srednjeg stupnja, dok je u urbanoj skupini dijagnostici-rana AMD bla`eg stupnja samo u 2.5%, tj. samo u dva pacijenta. U sli~noj je korelaciji i pojava eksfolijativnog sindroma,s mnogo vi{om incidencijom AMD u pacijenata s eksfolijativnim sindromom. Detaljnom anamnezom i poznavanjemstila `ivota svakog pojedinca, mo`e se zaklju~iti da je tako niska incidencija AMD i eksfolijativnog sindroma u urbanojpopulaciji prisutna stoga {to to stanovni{tvo `ivi u gradu s uskim ulicama i posljedi~no u velikoj hladovini, a kod sun~a-nja obavezno koriste za{titne nao~ale i sun~ani {e{ir.B. Vojnikovi} et al.: UV Sun Radiation and Incidence of ARMD on Island Rab, Coll. Antropol. 31 (2007) Suppl. 1: 43–4444TABLE 1THE APPEARANCE OF AGE-RELATED MACULAR DEGENERATION (AMD) ON THE ISLAND OF RAB IN POPULATION OFCHRONIC EXPOSURE TO UV-RADIATION (N=1371 PATIENTS, AGE 45–65 YEARS)Agriculturists and fishermen population (n=1300) Urban population (n=71)A. Central vision loss in 21 %0.7–0.8Central vision loss in 4%0.9–1.0B. Macular Thresholds increasing 20–50 asb, in 27% 5–10 asb, in 6%C. Pseudoexfoliation of lens capsule (possible glaucoma exists) in 28% 0.0%D. Fundus picture: AMD 18% AMD in 2.5%U:\coll-antropolo\coll-antro-suppl-1-2007\vojnikovic 4.vp9. veljaŁa 2007 12:46:49Color profile: DisabledComposite  150 lpi at 45 degrees

English

Ultraviolet Sun Radiation and Incidence of Age-Related Macular Degeneration on Croatian Island Rab

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Coll. Antropol. 31 (2007) Suppl. 1: 43–44Original scientific paperUltraviolet Sun Radiation and Incidenceof Age-Related Macular Degeneration onCroatian Island RabBo`idar Vojnikovi}1, Sanja Njiri}2, Miran ^oklo3 and Josip [panjol41 Eye Polyclinic »Dr. B. Vojnikovi}«, Rijeka, Croatia2 Eye Polyclinic »Dr. L. Pavi~evi}«, Rijeka, Croatia3 Department of Forensic Medicine, Rijeka University School of Medicine, Rijeka, Croatia4 Department of Urology, Rijeka University Hospital, Rijeka, CroatiaA B S T R A C TThis epidemiological study is completed on island Rab, located in North Adriatic Sea. For this study it is importantthat Adriatic Sea has one of the highest solar radiations in geographical area of Europe. The aim of this epidemiologicalstudy is to estimate correlation between incidence of Age-Related Macular Degeneration (AMD) and exposure of sunlightin two different populations on island Rab. In the first group of population of island Rab, agriculturists and fishermen(n=1300), incidence of AMD was in 18%, but in urban population only 2.5%. It is very interesting that correlation existsbetween incidence of AMD and exfoliation syndrome. In the group of chronic exposure to sunlight (agriculturists andfishermen) exfoliation syndrome exists in 28%, but in urban population it has never been seen. The age in both popula-tions was 45–65 years. We can conclude that there is a very significant correlation between chronic exposure to sunlightand appearance of AMD.Key words: AMD, exfoliation syndrome, exposure to sunlightIntroductionThrough a long period of time it is estimated that en-vironment is very significant risk factor in developmentof Age-Related Macular Degeneration (AMD)1–7. One ofthe most important climate factors in development ofAMD is increase of solar UV-radiation8–10. AMD is todayleading factor of vision loss in the world11,12. Ultravioletlight radiation with very high energy can lead to very se-rious damage, initiate deleterious biochemical reactions,to make photoproduct dimmers, damage nucleic acidsand consequently formed abnormal DNA13,15. Beside in-fluence on development of AMD, solar UV-radiation canalso initiate as a risk factor even in development of ocu-lar melanoma16. Histopathological alterations are mostlyknown in AMD7,17, but the future of solving a problem ofAMD is in the proteomic analysis18,19.The aim of this epidemiological analysis is to estimatethe influence of solar UV radiation as a risk factor in de-velopment of AMD on the island of Rab.Patients and MethodsThe island of Rab is geographically located in North ofthe Adriatic Sea (44°40’ N), with very high solar radia-tion. All patients (n=1371) were divided in two groups:population of agriculturists and fishermen (n=1300) andurban population (n=71). Their age was between 45 and65 years. All patients were examined in mydriasis withslit lamp-biomicroscopy, exe pressure and fundus pic-ture. This epidemiologic study is completed between theyears 2003 and 2005. Each patient was taken a very seri-ous anamnesis and style of life questions.Results and ConclusionIn table 1, incidence of AMD is presented in two dis-tinct groups: in the first group of agriculturists and fish-ermen population AMD is present in 18%, but in urbanpopulation in only 2.5% (2 patients only). Correlation be-43Received for publication October 1, 2006U:\coll-antropolo\coll-antro-suppl-1-2007\vojnikovic 4.vp9. veljaŁa 2007 12:46:48Color profile: DisabledComposite  150 lpi at 45 degreestween the appearance of AMD and exfoliation syndromeis very significant, 28% in the first group of agriculturistsand fishermen population.In this epidemiological study, it can be concluded thatthe appearance of AMD is significantly in correlationwith chronic exposure to sunlight UV-radiation.R E F E R E N C E S1. HAM WT Jr, MUELLER HA, RUFFOB JJ Jr, Am J Ophtalmol, 93(1982) 299. — 2. LERMAN S: Radiant energy and the eye. (MacMillan,New York, 1980). — 3. LUECKE A, REME CH, Klin Monatbl Augenhelik,184 (1984) 77. — 4. PEYMAN GA, ZAK R, J Am Intraocular Impl Soc, 9(1983) 161. — 5. SYKES SM, ROBINSON WG JR, WAXLER M, KUWA-BARA T, Investigat Ophtalmol Visual Sci, 20 (1981) 425. — 6. TSOMOM,WOODFORD BJ, Ophtalmology, 90 (1983) 952. — 7. VOJNIKOVI] B:Einsteinov zakon elementarne fotokemijske reakcije. (Veleu~ili{te VelikaGorica, Zagreb, 2005.). — 8. PENZAR B, PENZAR I, ORLI] M: Vrijeme iklima hrvatskog Jadrana (»Dr. Feletar«, Koprivnica, 2001). — 9. KANCRP, Int J Climat, 18 (1998) 457. — 10. LISAC I, Gospodarstvo i okoli{, 33(1998) 381 — 11. MUKESH BN, DIMITROV PN, LEIKIN S, WANG JJ,MITCHELL P, MCCARTY CA, TAYLOR HR, Ophtalmology, 111 (2004)1176. — 12. TAYLOR HR, KEEFFE JE, VU HT, WANG JJ, ROCHTCHI-NA E, PEZZULLOML, MITCHELL P, Med J Aust, 182 (2005) 565. — 13.RODNEY B: Concepts in Biochemistry (JohnWiley & Sons, Inc., Toronto,2002). — 14. BRUMEN V, GARAJ-VRHOVAC V, Sigurnost, 45 (2003) 107.— 15. HECK DE, GERECKE DR, VETIRANO AM, LASKIN JD, Toxicol-ogy and Applied Pharmacology, 195 (2004) 288. — 16. VAJDIC CM, KRI-CKER A, GIBLIN M, MCKENZIE J, AITKEN J, GILES GG, ARM-STRONG BK, Int J Cancer, 101 (2002) 175. — 17. MYRON Y, BEN SF:Ocular Pathology (JBLippincott Company, Philadelphia, 1989). — 18.ETHEN CM, REILLY C, FENG X, TIMOTHY WO, FERRINGTON DA,Source Invest OphtalmolVisual Sci, 47 (2006) 2280. — 19. NORDGAARDCL, BERG KM, KAPPHAHN R, REILLY C, FENG X, OLSEN TW, FER-RINGTON A, Source Invest Ophtalmol Visual Sci, 47 (2006) 815.B. Vojnikovi}Eye Polyclinic »Dr. B. Vojnikovi}«, Antuna Barca 3B, 51000 Rijeka, Croatiae-mail: decv@decv.comULTRAVIOLETNO SUN^EVO ZRA^ENJE I U^ESTALOST POJAVE SENILNE MAKULARNEDEGENERACIJE U POPULACIJI PU^ANSTVA OTOKA RABAS A @ E T A KU vremenskom periodu od 2003–2005. godine pregledana je 1371 osoba na otoku Rabu. Populacija je podijeljena udvije skupine: poljoprivrednici i ribari (1300 osoba) i u drugoj skupini urbano stanovni{tvo (71 osoba). U prvoj skupinipregledom fundusa dijagnosticirana je u 18% AMD, po~etnog i srednjeg stupnja, dok je u urbanoj skupini dijagnostici-rana AMD bla`eg stupnja samo u 2.5%, tj. samo u dva pacijenta. U sli~noj je korelaciji i pojava eksfolijativnog sindroma,s mnogo vi{om incidencijom AMD u pacijenata s eksfolijativnim sindromom. Detaljnom anamnezom i poznavanjemstila `ivota svakog pojedinca, mo`e se zaklju~iti da je tako niska incidencija AMD i eksfolijativnog sindroma u urbanojpopulaciji prisutna stoga {to to stanovni{tvo `ivi u gradu s uskim ulicama i posljedi~no u velikoj hladovini, a kod sun~a-nja obavezno koriste za{titne nao~ale i sun~ani {e{ir.B. Vojnikovi} et al.: UV Sun Radiation and Incidence of ARMD on Island Rab, Coll. Antropol. 31 (2007) Suppl. 1: 43–4444TABLE 1THE APPEARANCE OF AGE-RELATED MACULAR DEGENERATION (AMD) ON THE ISLAND OF RAB IN POPULATION OFCHRONIC EXPOSURE TO UV-RADIATION (N=1371 PATIENTS, AGE 45–65 YEARS)Agriculturists and fishermen population (n=1300) Urban population (n=71)A. Central vision loss in 21 %0.7–0.8Central vision loss in 4%0.9–1.0B. Macular Thresholds increasing 20–50 asb, in 27% 5–10 asb, in 6%C. Pseudoexfoliation of lens capsule (possible glaucoma exists) in 28% 0.0%D. Fundus picture: AMD 18% AMD in 2.5%U:\coll-antropolo\coll-antro-suppl-1-2007\vojnikovic 4.vp9. veljaŁa 2007 12:46:49Color profile: DisabledComposite  150 lpi at 45 degrees

Ultraviolet Sun Radiation and Incidence of Age-Related Macular Degeneration on Croatian Island Rab

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