Prevalence and determinants of age related macular degeneration in north Indian city of Dehradun, Uttarakhand

Abstract

Introduction: Age-related macular degeneration (AMD) is among the fourth leading cause of blindness in India after cataract, refractive errors and glaucoma. Aim and Objective: To find out magnitude and determinants of blinding AMD among patients presenting at a tertiary level eye care centre in Dehradun with this condition. Material and methods: This was a study of eye patients above age 45 years seen from July 2010 to October 2013. After taking preliminary information, optometrist noted the best-corrected vision. Ophthalmologists examined eyes using a slit-lamp bio-microscope. AMD was confirmed by fluorescein angiography and optical coherence tomography. The age, sex, history of smoking, sun exposure, family history of AMD, diet, body mass index (BMI), history of hypertension, dyslipidemia and diabetes were noted.  Results: Of the 14,698 patients seen, 221 had AMD (dry or wet) in at least one eye, the overall proportion of AMD being 1.50%. Of all AMD patients, 103 had blinding wet AMD (46.61%).Further analysis revealed that old age (71-80 years), male sex and history of hypertension, diabetes etc were significant risk factors of  wet AMD. Of the 221 patients with AMD, nearly a third, that is 71 patients (32.13%) had visual acuity of better eye < 3/60, which was taken as criteria for blindness. Conclusions: AMD does not seem to be a problem of public health magnitude in the study area. Age, being male, history of hypertension, diabetes etc are significant risk factors for wet AMD.