CLINICAL PRESENTATION AND RISK FACTORS OF AGE RELATED MACULAR DEGENERATION IN UNIVERSITY OF BENIN TEACHING HOSPITAL, EDO STATE, NIGERIA

Abstract

Aim: To determine the clinical characteristics and risk factors of Age-related Macular
Degeneration at the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria.
Study Design: A descriptive cross-sectional analytical study was carried out. A structured
interviewer-administered protocol was used.
Method: In this Hospital-based study, all consenting consecutive new patients aged 50 years
and above presenting at the out-patient clinic of the UBTH within the study period were
enrolled. A structured interviewer-administered protocol was used to obtain relevant
demographic and clinical information which included biodata, medical and social history,
ocular history, anthropometric measurements and ocular examination. Standard photographs
from the International ARM Epidemiological Study Group were used to grade ARMD
related fundus changes. Registered participants had their fasting blood glucose and serum
lipid profiles checked. Data was cleaned and analysed using the Statistical Product for
Scientific Solutions version 20 software (SPSS Inc, Chicago IL., U.S.A.).
Results: A total of 240 respondents (120 cases made up of 40% males, 60% females and 120
age and sex matched controls made up of 40.8% males and 59.2% females),were enrolled
from December 2015 – June 2016. The higher proportion of respondents in both study groups
were in the age group 60 – 69 years; cases 48 (40.0%) and controls 49 (40.8%). There was a
female preponderance in cases of ARMD seen (60%). A year increase in the age of
respondents led to 1.13 increase in the odds of developing ARMD. Cigarette smoking led to a
higher risk 0.76 (95% CI: 0.46 – 4.54) of developing AMD than non-smokers. Myopia was
found to be significantly more common among cases with ARMD than in the controls. Early
ARMD was the predominant pattern seen, with hard drusen and retinal hyperpigmentation
being more predominant. Two cases of late ARMD were seen with features suggestive of
neovascular ARMD.
Conclusion: There was a greater preponderance of ARMD among females. The presence of
lens opacities and increasing age were significantly associated with increased risk of Age
related Macular Degeneration. The risk of having ARMD was shown to be reduced in
subjects with increasing level of education and the use of tinted or photochromic lenses. The
presenting pattern is predominantly the early type. The clinical features are largely
characterised by reduction in visual acuity, especially for the late type where it is more
marked, the presence of retinal hyperpigmentation and hard drusen.

CLINICAL PRESENTATION AND RISK FACTORS OF AGE RELATED MACULAR DEGENERATION IN UNIVERSITY OF BENIN TEACHING HOSPITAL, EDO STATE, NIGERIA