14-year incidence, progression, and visual morbidity of age-related maculopathy: the Copenhagen City Eye Study

Ophthalmology. 2005 May;112(5):787-98. doi: 10.1016/j.ophtha.2004.11.040.


Purpose: To describe the 14-year incidence of age-related maculopathy (ARM) lesions and the related visual loss.

Design: Population-based cohort study.

Participants: Nine hundred forty-six residents (age range, 60-80 years) of Copenhagen participated in the study from 1986 through 1988. Excluding participants who had died since baseline, 359 persons (97.3% of survivors) were reexamined from 2000 through 2002.

Methods: Participants underwent extensive ophthalmologic examinations. Age-related maculopathy lesions were determined by grading color fundus photographs from the examinations using a modified Wisconsin Age-Related Maculopathy Grading System.

Main outcome measures: Incidence of drusen type and size, pigmentary abnormalities, pure geographic atrophy, exudative ARM, visual impairment, and blindness.

Results: The 14-year incidences of early and late ARM were 31.5% and 14.8%, respectively. Individuals 75 to 80 years of age at baseline had significantly (P< or =0.05) higher 14-year incidences of the following lesions than those aged 60 to 64 years: medium or large drusen (> or =125 microm; 34.2% vs. 12.8%, respectively), soft drusen (45.2% vs. 21.4%), pigmentary abnormalities (31.4% vs. 17.0%), pure geographic atrophy (17.4% vs. 1.0%), and exudative ARM (23.3% vs. 5.7%). Severe drusen type, large drusen, and retinal pigmentary abnormalities at baseline were important predictors of incident late ARM. The 14-year incidences of visual impairment (<20/40 but >20/200) or legal blindness from late ARM were 6.0% and 3.4%, respectively. Late ARM caused 35.7% of all visual impairment and 66.7% of all blindness.

Conclusions: There is a high incidence of ARM lesions in this elderly white population. Severe drusen type and size or a combination of drusen and pigmentary abnormalities significantly increases the risk of developing late ARM, the most frequent cause of legal blindness in this population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Denmark / epidemiology
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Macular Degeneration / epidemiology*
  • Macular Degeneration / physiopathology
  • Male
  • Middle Aged
  • Retinal Drusen / epidemiology
  • Retinal Drusen / physiopathology
  • Retinitis Pigmentosa / epidemiology
  • Retinitis Pigmentosa / physiopathology
  • Risk Factors
  • Vision Disorders / epidemiology*
  • Vision Disorders / physiopathology
  • Visual Acuity
  • Visually Impaired Persons / statistics & numerical data*