Age-Related Macular Degeneration Occurs Earlier Than Presumed

Researchers at Johannes Gutenberg University (JGU; Mainz, Germany) evaluated fundus photographs of 4,340 subject (35–74 years of age) participating in the Gutenberg Health Study (GHS), a single-center study in the Rhineland-Palatine region of Germany. Fundus images were evaluate and classified by vascular structure, the head of the optic nerve, and the macula of the eye. They were also graded independently by two experienced ophthalmologists, based on the presence of hard and soft drusen, retinal pigmentary abnormalities, and signs of atrophic or neovascular AMD.

The results revealed that the incidence of AMD increases with age, and that even persons under the age of 50 years could already be affected by early stage AMD; in the age group of 35- to 44-year-olds, 3.8% of the subjects were found to be suffering from the disease. On average, about 12% of all participants had early stage AMD, but only 0.2% exhibited symptoms of late stage AMD, which is often associated with severe visual impairment. The study was published ahead of print on February 25, 2014, in Graefe's Archive for Clinical and Experimental Ophthalmology.

“Our research shows that age-related macular degeneration can already occur much earlier than previously thought. This means there may also be possible consequences with regard to the screening examinations for these diseases,” concluded lead author Christina Korb, MD, and colleagues. “The findings thus contradict the current assumption that AMD only occurs in the section of the population that is over 50 years old.”

AMD is a medical condition that is a major cause of blindness and visual impairment in older adults due to damage to the retina in the center of the visual field (the macula). AMD, which occurs in dry and wet forms, make it difficult or impossible to read or recognize faces, although enough peripheral vision remains to allow other activities of daily life. In the dry (nonexudative) form, cellular debris called drusen accumulates between the retina and the choroid, and the retina can become detached. In the more severe, wet (exudative) form, blood vessels grow from the choroid behind the retina, and the retina can also become detached.

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Johannes Gutenberg University Mainz