Epidemiology of Age-related Maculopathy

In 1875, Pagenstecher and Gentll provided the first description of age-related\ (ARM). Nowadays, hundred and twenty years after the first\, ARM is one of the major causes of severe irreversible visual loss\ the elderly in western countries. It has been estimated that there are 640000\ aged 75 years or older in the United States who have signs of the\ of this disease. Still, Olll\\' knowledge about the etiology of ARM is\ limited and treatment is only possible in a minority of patients. \ Framingham Eye Study was the first population-based study that\ information about prevalence and risk factors for ARM. Since then, \ epidemiologic studies on the disease have been performed, most of them\ the USA. A review of the epidemiological knowledge obtained in these studies\ given in chapter 2 of this thesis. Since until recently a uniform classification\ ARM has not been available, comparison of the results of different studies has\ years been a problem. Chapter 3 presents the results of several international\ of six research groups with the aim to develop a uniform classification\ for ARM. \ information was available on the prevalence of ARM in the Netherlands. \ Rotterdam Study, however, provided an excellent opportunity to answer\ research questions into the epidemiology of the disease. The results of the\ study are presented in chapter 4. The remainder of this thesis focuses\ risk factors of the late stages of the disease, atrophic and neovascular agerelated\ degeneration (AMD). In chapter 5, the associations of various\ of atherosclerosis and the late stages of the disease are described. \ 6 presents the association between smoking and AMD and in chapter 7\ relation with age of menopause and is described. Methodological issues related\ the presented studies are discussed in chapter 8, together with a review of the\ of these studies and suggestions for future research.