MACULAR DEGENERATION:CLINICAL ANALYTICAL STUDY

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

HYDERABADINDIA

NO FINANCIAL AID TO THIS STUDY

AGE RELATED MACULARDEGENERATION IS THE LEADINGCAUSE 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, ENVIRONMENTALAND NUTRITIONAL.

NO PROVEN TREATMETN IS AVAILABLE, NEITHER SLOWS OR PREVENT THE PROCESS OF ARMD [AREDS REPORT-2001]

INCIDENCE IS RAPIDLY INCREASING WITH AGE9% INVOLVES ABOVE 65 Yrs30% 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 UNDERSTANDINGOF 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 PERCENTAGECASES

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 PERCENTAGECASES

HIGHER 1900 42.2%MODERATE 1600 35.5%LOW 1000 22.2%

SMOKING

GROUP NO. OF PERCENTAGECASES

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 PERCENTAGECASES

CARBOHYDRATES 1300 28.8%FATTY 1500 33.5%PROTEINS 1000 22.2%NUTIRTIOUSSUPPLIMENTATION 700 18.8%

DIABETIC PATTERS

GROUP NO. OF PERCENTAGECASES

VEGETARIAN 2000 44.5%NON

VEGETARIANS 2500 55.5%

YOGA / MEDITATION

GROUP NO. OF PERCENTAGECASES

YOGA 2000 44.5%NON YOGA 2500 55.5%

H/o OF MEDICATIONGROUP 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 PERCENTAGECASES

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 2008SRINIVAS 2005

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

OCCUPATIONAL FACTORSHOWS THAT EXECUTIVES ARE MORE INVOLVED THAN THEIR COUNTER PARTS

FOOD HABITS WISE DISTRIBUTIONHAS SHOWS THAT FATTYINTAKING PROPLE WERE MORE AMONG THEIR COUNTER PARTS, MAY BE CHOLESTROLINCREASING TENDENCY.

IT IS OBSERVED INCIDENCE IS LOWER AMONG VEGETARIANS i.e., 44.5 MAY BE HIGHER CONTENT OFANTIOXIDENTS, BETA-CARATENE, VIT-C AND SOME MICRO NUTRIENTS MAY HELP TO DELAY OR ARREST ARMD

SRINIVAS-2009SRINIVAS-1986

VEGETARIAN IS COMMON IN INDIA AND 60% OF INDIAN AND 20% OF THE WORLD POPULATION AREVEGETARIANS.

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 / METABOLICDISORDERS, HYPERLIPIDAMIA IS THE HIGHER INVOLVEMENT i.e., 22.2% AMONG OTHER CONDITIONS.

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