| Summary: | 博士 === 國立陽明大學 === 公共衛生研究所 === 96 === Age-related macular degeneration is a common eye disease with irreversible central visual loss in the elderly people in the developed countries. The population-based study with photographic grading, international classification and incidence rate of this blinding eye disease in the Chinese people had not been reported in Taiwan or in the literatures before. In 1999, the Shihpai eye study was conducted with 1361 elder people attended the ocular examination. Among the 1058 (77.7%) participants with gradable photographs, the prevalence rate of early and late AMD was 9.2% and 1.9%, respectively. Age was the most significant risk factor associated with both early and late AMD. The prevalence of early AMD rose from 5.0% in the 65-69 year age group to 24.4% in those aged 80 years and over; and for late AMD, from 1.0% to 9.0%. Those who currently drank alcohol had lower rate of early AMD than the non-drinker (adjusted odd ratio 0.32, 95% CI: 0.11-0.93, p=0.037). Smoking habit had no association with prevalent AMD. In 2006, the cohort was invited to participate the second ocular examination. Among the 480 participants, 402 (83.8%) had gradable photographs and were analyzed for the incidence study. The 7-year cumulative incidence of early and late AMD was 7.9% and 1.7%, respectively. Age was still the most significant factor for any AMD progression. Age of 80 and older at baseline had 11.9 fold (95% CI:3.06-46.24, p<0.0001) of acquiring any AMD than age 65-69 at baseline. Smoking and alcohol drinking were not risk factors for the incident AMD. Specific fundus lesions of >10 small hard drusen, intermediate drusen at baseline were associated with progression of early AMD while large distinct or indistinct drusen, drusen area>500um and pigment abnormalities were associated with late AMD comparing to those without the lesions. The comparable rate of AMD to other developed countries and ethnos in the world confirmed that AMD is a common eye disease among the elderly people in Taiwan. The impact of this blinding eye disease on the aging society of Taiwan as well as their early detection and preventive intervention deserve further researches.
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