Associated factors for age-related maculopathy in the adult population in southern India: the Andhra Pradesh eye disease study

Abstract

Background: To assess prevalence, potential risk factors and population attributable risk percentage (PAR) for age-related maculopathy (ARM) in the Indian state of Andhra Pradesh. Methods: A population-based study, cross-sectional epidemiological study was conducted in the state of Andhra Pradesh in India during 1996 and 2000. Participants from 94 clusters in one urban and three rural areas representative of the population of Andhra Pradesh underwent a detailed interview and a detailed dilated ocular evaluation by trained professionals. This report presents the prevalence estimates of ARM and examines the association of ARM with potential risk factors in persons aged 40-102 years (n=3723). ARM was defined as per the international classification and grading system. Results: ARM was present in 327 subjects, an age-gender-area-adjusted prevalence of 8.9% (95% confidence interval (CI), 8.1% to 9.9%). Multivariate analysis showed that, the adjusted prevalence of ARM was significantly higher in those 70 years of age or older (adjusted odds ratio (OR), 3.65; 95% CI 2.24 to 5.94) and in subjects with hypertension OR 1.30 (95% CI 1.02 to 1.65). The presence of any cataract and urban residence were significantly associated with increased prevalence of ARM (OR 1.67; 95% CI 1.27 to 2.21 and 2.30; 95% CI 1.79 to 2.96) respectively. Increased intraocular pressure (IOP) and increased cup-to-disc ratio (CDR) were also significantly associated with increased prevalence of ARM (OR 1.03; 95% CI 1.002 to 1.06 and 2.25; 95% CI 1.10 to 4.67) respectively. The PAR for hypertension and any cataract was 12% and 18% respectively in this population. Conclusion: The prevalence of ARM in this south Indian population is similar to those reported from other developed countries. Increased age, increased IOP and increased CDR were significantly associated with the increased risk of ARM.