Analysis Of Factors Related To Age-related Macular Degeneration

Objective: Age-related macular degeneration (AMD) is a degenerative disease of the macular and the leading cause of nonreversible blindness. AMD is the leading cause of blindness over the world. The incidence is increasing with the tendency of outstanding population aging in China and to be a public health problem. Although there are a lot of basal and clinical researches, the pathogens and pathogeneses of AMD are unknown. Most scholar account that it is a multifactor disease, and they have therefore concentrated on the identification of risk factors associated with the development and progression of AMD to find modifiable factors so that patients can be advised on how to prevent the development of AMD. The epidemiological studies are very important because of the increasing incidence and lacking effective treatment. Currently the main risk factors are including individual factors, eyes factors, body condition, hyperlipoidemia, environment, and lifestyle and so on. In this article, we explore the possible risk factors of AMD and find more effective prevent methods.Methods: A group comparing case-control study was carried out. Two hundreds AMD inpatient (≥45y) were random sample in a certain hospital from 2003 to 2008. The controls were two hundreds samples without AMD (≥45y). All the participants underwent standard eye examination, including sight, cornea, pupil, lens, the fundus oculi etc. The simples with the nuclear cataract 2 or more were not involved in the inclusion criteria. The diagnostic criteria were in strict accordance with the "diagnostic criteria of AMD" which development in the second session of the ocular fundus Academic Council. Stereoscopic color fundus oculi photographs and fundus fluorescein angiography were used to the cases. The accurate diagnoses were establishment according the results by two physicians to discuss and proofreading. Uniform questionnaires were administered to obtain demographic information and exposure information, such as age, gender, Eye Do, height, weight, educational level, blood pressure, eye examinations, smoking history, drinking history, sun exposure, history of hypertension, history of diabetes, cervical history, blood glucose, triglycerides, total cholesterol, high density lipoprotein , low-density lipoprotein and visual acuity etc. Omission of information conducted a telephone serve; there were serious discrepancies in the information removed. Application of Excel to establish a data base, and using SPSS13.0 software package established databank. According the data of 16 content to analysis the basis of single factor. Then statistical analyses of multifactor non-conditional Logistic regression were performed to screen the risk factors.Results: 199 patients with AMD which include male 99(50.5%),female 100 (49.5%),mean age 59.4±10.9y(45-88y) were compared with 199 controls which include male 97(49.5%),female 102(50.5%), mean age 57.4±10.4y(45-82y). The data of AMD cases and controls have comparability by balanced test with regard to age and gender. Statistical analysis of Logistic regression displayed that ultimate factors, such as smoking, total cholesterol, triglyceride, low-density lipoprotein, illumination time, and career. In order to prevent the role of confounding factors, all significant variables were accessed to multi-factor analysis. Analysis variables were improved logistic multivariate analysis model. The multi-factors Logistic regression show that smoking (χ2=18.088,P <0.001), low-density lipoprotein (χ2=21.005,P<0.001), time of sunlight exposure (χ2=17.190,P <0.001), hypertension(χ2=20.617,P <0.001), occupation(1)(P=0.007<0.05),occupation(3)(P=0.010<0.05),high-density lipoprotein (P=0.024<0.05),cholesterol (P=0.022<0.05) have conspicuous statistical difference. Among the factors, smoking, low-density lipoprotein, illumination time, high blood pressure, occupation, total cholesterol was risk factors, while high-density lipoprotein was a protective factor. Conclusion:The result of this study shows some factors such as smoking, hypertension, time of sunlight exposure , low-density lipoprotein, métier, and total cholesterol are the risk of AMD. At the same time we found that high-density lipoprotein was the protective factors. Therefore, to promote smoking cessation can prevent the disease of AMD and improve the symptom of AMD patients. To promote a reasonable low-fat diet and a correct way of life are also important to prevent AMD. The results can be seen from the subject that it's not the single factor but many multi-levels multidimensional factors what through the whole range of the disease development. There is no effective treatment to AMD now. So it is important to realize the risk factors. We can take effective measures to promote screening for high-risk population, to facilitate early diagnosis and early prevention of AMD, and help us find the measures to reduce hazards and improved treatment.