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Epidemiology of ophthalmic conditions and their association with ocular and systemic diseases in Germany. An interdisciplinary work within the Gutenberg health study

Session Details

Session Title: AMD I

Session Date/Time: Friday 12/09/2014 | 08:00-10:00

Paper Time: 08:08

Venue: Boulevard C

First Author: : H.Elbaz UK

Co Author(s): :    T. Peto   R. Höhn   G. Zur Hausen   P. Wild   A. Mirshahi   N. Pfeiffer

Abstract Details


To explore the prevalence and incidence of several eye diseases and their association with other ocular conditions, systemic diseases and socioeconomic factors using baseline ophthalmic data of the Gutenberg Health Study (GHS).


Examination, testing and all data management for the GHS including its ophthalmic division took place in the University hospital of Mainz in Germany. Baseline data and images were collected of 15,010 patients between 2007 and 2012.


Of the 15,010 randomly selected participants of the region of Mainz and Bingen in Germany, ophthalmological and medical examination were completed on 14,700 subjects. Participants were aged between 35 and 74 years at the time of data collection. The sample was stratified 1:1 for gender and residence (urban and rural) and stratified equally for age group. The exclusion criteria were insufficient knowledge of the German language and the inability to participate in the examinations at the study centre. The ophthalmic tests include the examination of visual acuity and refraction, intraocular pressure, visual field, pachymetry/keratometry, slit lamp biomicroscopy, anterior segment tomography, ocular biometry and optical coherence tomography. Other general medical conditions were assessed through obtaining the history of present illness, cardiovascular risk factors and subsequently performing diabetes screening, ECG, blood pressure measurement, spirometry and carotid ultrasonography. So far, the fundus images of the first 5000 patients were graded at the Moorfields Eye Hospital Reading Centre, London, UK. All study-related activities were performed according to “Good Clinical Practice”, “Good Epidemiological Practice” and adhered to the tenets of the declaration of Helsinki.


The mean age of the participants was 55.0 ± 11.1 years. Male participants represented 50.5% versus female 49.5%. The prevalence of arterial hypertension was 49.6 %, diabetes mellitus 7.5 % and obesity 25.2 %. Of the first 5000, 4340 had gradable fundus images for AMD, of these small hard drusen were found in 37.4 %. Early AMD (soft drusen, pigmentary abnormalities) was present in 3.8 % of individuals in the youngest age group (35-44 years) and in 24.2% in the oldest age cohort (65-74 years). In all age groups, signs of early AMD were detected in 11.9 % of individuals, no signs of late AMD were found in the youngest age group. Late AMD (geographic atrophy or neovascular AMD) was found in 0.2 % of individuals. The evaluation of Optic disc images revealed a negative association between optic nerve drusen and myopia and a positive association between elevated IOP and visual field defects in the presence of optic disc drusen. In 922 participants, the prevalence of prediabetes was 22.4 %, and of Diabetic Retinopathy (DR) 8.1 % (7.2% mild; 0.5% moderate and 0.3% with severe DR). Prevalence of Diabetic maculopathy was 0.2%. None of the subjects had proliferative DR.


The continuous demographic changes and the increase in the life expectancy in Europe necessitate the continuous evaluation of the epidemiology of eye diseases to help understand their aetiology, risk factors and develop new treatment modalities. The size and setting of the GHS cohort and its interdisciplinary structure allow a good and accurate data management for generating population-based results and the results of this study will aid appropriate health care planning for this region in Germany.

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