The epidemiology of retinal reticular drusen

PURPOSE: To describe the prevalence and 15-year cumulative incidence of and risk factors for reticular drusen. DESIGN: Population-based prospective study. METHODS: Four thousand nine hundred and twenty-six persons, 43 to 86 years of age, were included between 1988 and 1990, of whom 3 684, 2,764, and 2,119 participated in five-, 10-, and 15-year follow-up examinations, respectively, in Beaver Dam, Wisconsin. Main outcome measures included prevalence and 15-year incidence of reticular drusen determined by grading stereoscopic color fundus photographs. RESULTS: The prevalence at baseline and the 15-year cumulative incidence in either eye of reticular drusen was 0.7% and 3.0%, respectively. The 15-year incidence of reticular drusen varied with. age from 0.4% in those 43 to 54 years of age to 6.6% in those 75 years or older at baseline (P <.001). In a multivariate model, while controlling for age, risk factors statistically significantly associated with increased risk of incident reticular drusen included: being female (odds ratio [OR], 2.8), current smoking (OR vs never, 1.9), less education (OR per category, 1.7), B-vitamin complex use (OR vs none, 2.5), single vitamin B (OR vs none, 2.9), history of steroid eye drops use (OR, 5.9), glaucoma (OR, 2.8), and more severe drusen type (e.g., soft indistinct drusen; OR, 1.4), whereas diabetes (OR, 0.1) at baseline was associated with decreased risk. Right eyes with reticular drusen at baseline had higher cumulative incidence of geographic atrophy (21% vs 9%) and exudative age-related macular degeneration [AMD] (20% vs 10%) compared with eyes with soft indistinct drusen. CONCLUSIONS: This population based study documents the long-term cumulative incidence of reticular drusen and its risk factors and shows its association with a high risk of incident late AMD.