A population based study on prevalence and risk factors of age related macular degeneration in North of Iran: The Gilan Eye Study

Purpose: To estimate the prevalence and risk factors of age related macular degeneration (AMD) in Gilan province, north of Iran.Methods: This population based cross sectional study was carried out on 2975 individuals from Gilan, Iran, aged ≥50 years, in 2014. Color fundus photographs were evaluated to determine the prevalence of different grades of AMD using International Age-related Maculopathy Epidemiological Study Group grading system. The relationship between AMD and different risk factors were evaluated.Results: Out of 2975 anticipated individuals, 2587 subjects participated in the study (87.0% response rate) and 2275 subjects (62.6 ± 8.8 years old) had gradable fundus photographs. The age and sex- standardized prevalence of early and late AMD were 13.2% (95% confidence interval [CI], 10.6 to 16.2) and 0.7% (95% CI, 0.4 to 1.3), respectively. The prevalence of neovascular (NV) AMD and geographic atrophy (GA) were 0.26% (95% CI, 0.08 to 0.48) and 0.35% (95% CI, 0.17 to 0.66), respectively. The prevalence of early and any AMD significantly increased with age (P=0.001 and P<0.001, respectively). In multivariate analysis, diabetes (AOR = 1.66, 95% CI, 1 to 2.76) and outdoor working ≥ 4 hours a day (AOR= 4.24, 95% CI 1.27 to 14.14) were risk factors of any AMD and late AMD, respectively. However, myopia (AOR= 0.12, 95% CI, 0.02 to 0.9) was the protective factor against late AMD. No significant association was found between AMD and sex, smoking status, hypertension, pseudophakia, hyperlipidemia and iris color.Conclusion: This first detailed estimate of the AMD prevalence in Iranian can be considered in designing health programs and enhancing rehabilitation services for the affected subjects