MACULAR DEGENERATION:CLINICAL ANALYTICAL STUDY

Dr. C. SRINIVAS, M.DNIZAMIA GENERAL HOSPITAL, PVRI

HYDERABADINDIA

NO FINANCIAL AID TO THIS STUDY

AGE RELATED MACULAR

DEGENERATION IS THE LEADING

CAUSE OF BLINDNESS IN THE WORLD

[AREDS REPORT-2001]

45% VISUAL DISABILITY IN THE USA

DUE TO ARMD [KLEIN et al –1992]

10 MILLION PEOPLE IN THE USA

[FRIEDMAN.DS COLAMAIN.BJ 2004]

PREVALANCE IS INCREASING IN GREATBRITAN – (EIANS et al 1996) AND IN JAPAN [MARUO 1991] INCREASING RAPIDLY IN DEVELOPING COUNTRIES AND IN INDIA TOO.

IS A COMPLEX MULTIFACTORIAL

DISORDER (STAURT RICHER et al 2004)

INVOLVES GENETIC, C.V, ENVIRONMENTAL

AND NUTRITIONAL.

NO PROVEN TREATMETN IS

AVAILABLE, NEITHER SLOWS OR

PREVENT THE PROCESS OF ARMD

[AREDS REPORT-2001]

INCIDENCE IS RAPIDLY INCREASING WITH AGE

9% INVOLVES ABOVE 65 Yrs

30% INVOLVES ABOVE 75 Yrs [VAN NEW KRIK 2000]

50% AFFECTS BY 2020 AD [FREDMAN.DS 2004]

EDIDEMIOLOGICAL STUDIES MAY NOT

BE ABLE TO FIND THE UNDERSTANDING

OF THE ARMD. BUT HELPS TO ASSES THE

CONTRIBUTING FACTOR TO REDUCE THE

ECONOMICAL, SOCIAL, NATIONAL

GLOBAL AND PERSONAL PROBLEMS

MATERIAL AND METHODS

4500 MACULAR DEGENARATION CASES

CLINICALLY SELECTED AND ANALYTICALLY

STUDIED TO ASSES THE VARIOUS AETIO

PATHOGENIC FACTOR IN NIZAMIA GENERAL

HOSPITAL FOR A DECADE

SEX WISE DISTRIBUTION

SEX NO. OF PERCENTAGE CASES

MALE 2500 55.5%FEMALE 2000 44.5%

TYPES OF MACULAR DEGENERATION

TYPE NO. OF PERCENTAGE

CASES

WET 1700 37.7%

DRY 2800 62.44%

AGE WISE DISTRIBUTION

AGE NO. OF PERCENTAGE

CASES

40-49 500 11.1%

50-59 700 15.5%

60-69 900 20%

70-79 1300 28.8%

80-89 1100 24.4%

URBAN AND RURAL DISTRIBUTION

GROUP NO. OF PERCENTAGE

CASES

URBAN 3000 66.6%

RURAL 1500 32.6%

OCCUPATIONAL DISTRIBUTION

GROUP NO. OF PERCENTAGE

CASES

EXECUTIVE 2000 44.4%

NONEXECUTIVE 1500 32.6%

AGRICULTURE 1000 22.2%

SOCIO-ECONOMICAL DISTRIBUTION

GROUP NO. OF PERCENTAGE

CASES

HIGHER 1900 42.2%

MODERATE 1600 35.5%

LOW 1000 22.2%

SMOKING

GROUP NO. OF PERCENTAGE

CASES

SMOKERS 2400 53.3%

NON SMOKERS 2100 46.6%

ALCOHOL

GROUP NO. OF PERCENTAGE

CASES

ALCOHOLICS 2500 55.5%

NON ALCOHOLICS 2000 44.5%

FOOD HABITS

GROUP NO. OF PERCENTAGE

CASES

CARBOHYDRATES 1300 28.8%

FATTY 1500 33.5%

PROTEINS 1000 22.2%

NUTIRTIOUS

SUPPLIMENTATION 700 18.8%

DIABETIC PATTERS

GROUP NO. OF PERCENTAGE

CASES

VEGETARIAN 2000 44.5%

NON

VEGETARIANS 2500 55.5%

YOGA / MEDITATION

GROUP NO. OF PERCENTAGE

CASES

YOGA 2000 44.5%NON YOGA 2500 55.5%

H/o OF MEDICATION

GROUP NO. OF PERCENTAGE

CASESSTERIODS 750 16.5%ANTI BIOTICS 700 15.5%ANTI HISTAMINS 600 13.3%ANTI INFLAMATORY 650 14.4%ANTI DIABETIC 1000 22.2%ANTI HTN 800 17.5%

SYSTEMIC / METOBOLIC DISORDERS

GROUP NO. OF PERCENTAGE

CASES

HTN 800 17.5%

DM 700 15.5%

CVD 750 16.6%

HYPERLIPIDIAMIA 1000 22.2%

THYROID 650 14.4%

HARMONAL 600 13.3%

DISCUSSIONS

EXTENSIVE EDIDEMIOCOLOGICAL STUDIES CARRIED IN THE WORLD. ITSPRECISE AETIOLOGY IS UNKNOWN BUT MAY BE INCREASING OF LONGIVITY,CHANGE OF THE LIFE STYLE FOOD,HABITS, AND POLLUTION MAY CAUSE THE ARMD.

MALES ARE SIGNIFICANTLY HIGHER THAN THE FEMALES.

DRY TYPE OF ARMD IS HIGHER IN THIS STUDY

URBAN PEOPLE [66.6%] ARE MORE INVOLVED THAN RURAL FOLK MAY BE POLLUTION, AND AWAY FROM THE NATURE

AGEWISE DISTRIBUTION SHOWS THAT 70-79 YEARS WERE MORE AFFECTED THAN OTHER GROUPS MAY BE DUS TO SELEROTIC CHANGE, METOBOLIC CHANGES, AND RELATED CHANGES, LONGIVITY IS INCREASING AND ALSO PEOPLE MAY INCREASE 606 MILLION IN 2000 TO 1.2 BILLION BY 2025.

JENNIFER EVANS 2008

SRINIVAS 2005

IN THE SOCIO-ECONOMICALGROUOP, HIGHER SOCIOECONOMICAL GROUP WERE FOUND TO BE MORE THANTHE OTHER GROUPS MAY BE THEIR FOOD HABITS, LIFE STYLES.

OCCUPATIONAL FACTOR

SHOWS THAT EXECUTIVES ARE

MORE INVOLVED THAN THEIR

COUNTER PARTS

FOOD HABITS WISE DISTRIBUTION

HAS SHOWS THAT FATTY

INTAKING PROPLE WERE MORE

AMONG THEIR COUNTER PARTS,

MAY BE CHOLESTROL

INCREASING TENDENCY.

IT IS OBSERVED INCIDENCE IS

LOWER AMONG VEGETARIANS i.e.,

44.5 MAY BE HIGHER CONTENT OF

ANTIOXIDENTS, BETA-CARATENE,

VIT-C AND SOME MICRO

NUTRIENTS MAY HELP TO DELAY

OR ARREST ARMDSRINIVAS-2009

SRINIVAS-1986

VEGETARIAN IS COMMON IN

INDIA AND 60% OF INDIAN

AND 20% OF THE WORLD

POPULATION ARE

VEGETARIANS.

LEO. TOLSTOY, ALBERT

EINSTEIN, NEWTON,

SHAKSPEAR, BERNARD

SHAH, SOCRATES, AND

GANDHI WEREVEGETARIANS.

YOGA PRACTITIONERS ARE LESSER i.e., 44.5, THAN NON YOGA PRACTITIONERS MAY INCREASE THE 02

SRINIVAS 2001

SMOKERS [53.3%] INVOLVEMENT IS

HIGHER THAN NON SMOKERS, MAY

INCREASE THE OXIDATIVE STRESS[HAMMOND. BR 1996]

ALCOHOLICS [55.5%] ARE

MORE THAN NON ALCOHOLICS

AMONG MEDICATION

HIGHER OF 22.2 IS SEEN IN

THE ANTI DIABETIC DRUGS

SYSTEMIC / METABOLIC

DISORDERS, HYPERLIPIDAMIA IS

THE HIGHER INVOLVEMENT i.e.,

22.2% AMONG OTHER CONDITIONS.

THANK YOU