Prevalence of Early and Late Age-Related Macular Degeneration in India: The INDEYE Study

PurposeTo describe the prevalence of early and late Age-Related Macular Degeneration (AMD) in older people in India. MethodsPeople aged 60 years and older identified using random cluster-sampling in 2 study centres in south and north India, attended an eye examination. Digital fundus images were graded at a single reading centre according to the International Classification System and were stratified into 5 exclusive stages. Results2821 people (79% response rate) in north India and 3079 (78%) in south India attended an eye examination. 27% of participants with photographs could not be graded, mainly due to dense opacities, and are included in the denominator of prevalence estimates. The prevalence of late AMD was 0.9% (95% CI 0.7-1.1) and similar in the two centres (p=0.452), comprising mainly of neovascular AMD (44 of 53 cases). For early AMD, the prevalence of stage 1 (soft distinct drusen or pigmentary irregularities) was 28.8% (95% CI 27.0-30.6) with no difference seen between the centres (p=0.113). Differences were observed for stage 2 (soft distinct drusen with pigmentary irregularities or soft indistinct or reticular drusen), 3.8% (95% CI 2.7-5.0) in north India and 6.0% (95% CI 5.2-6.7) in South India, and for stage 3 (soft indistinct or reticular drusen with pigmentary irregularities), 0.04% (95% CI 0-0.1) in north India and 0.3% (95% CI 0.1-0.6) in south India. ConclusionsThe prevalence of early AMD (stages 1 and 2) is similar to that observed in western populations but stage 3 and late AMD prevalence appear to be lower. These estimates however are conservative because of the high proportion of ungradeables