Refractive status and the 5-year incidence of age-related maculopathy: the Blue Mountains Eye Study

This study aimed to assess the longitudinal association between refraction and 5-year incident age-related maculopathy (ARM) in the Blue Mountains Eye Study population. The dataset included 3654 participants aged 49+ (82.4% of eligible) examined at baseline (1992-1994), and 2335 (75.1% of survivors) examined after 5 years. Retinal photograph grading followed the International ARM Classification. Incident ARM was assessed using a side-by-side comparison. Refraction was performed using autorefraction with subjective refinement. Spherical equivalent was calculated from spherical plus half the cylindrical power. After adjusting for age, sex and smoking, no association was found between baseline spherical equivalent and 5-year incident late or early ARM. Hyperopic right eyes had slightly higher incident rates for late (0.8%) and early (6.3%) ARM, compared with myopic (0.4% and 4.1%, respectively) or emmetropic (0.5% and 5.0%, respectively) right eyes. After multivariable adjustment, this study found no significant association between hyperopia and the 5-year incidence of late or early ARM. Left eyes or the combined data from both eyes had similar findings.