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American Journal of Ophthalmology - AJO 02 91 R 1 revised (Page 6)

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American Journal of Ophthalmology - AJO 02 91 R 1 revised
Freeman, Cataract Surgery and Age-Related Macular Degeneration
late AMD was a cause of blindness (vision<=20/200). Early AMD was not assessed.
Information was also collected on age, sex, and smoking habits through an interviewer-
administered questionnaire.
For this analysis, late AMD was defined as choriodal neovascularization or geographic
atrophy present as assessed by clinical exam, or if late AMD was determined to be a cause of
blindness (20/200 or worse). Presence of severe cataract was defined as nuclear sclerosis grade
4, cortical opacification >=8/16, or any PSC opacification as graded clinically
Late AMD was clinically assessed in 9,478 out of 9,548 eyes. Reasons for not being able to
assess late AMD included inability to dilate the pupil, refusal of the participant, and significant
corneal opacity.
Study Population: Baltimore Eye Survey
The Baltimore Eye Survey (BES), also population-based, is a study of ocular disease and
vision loss among 5,308 black and white residents of Baltimore, MD, 40 years of age or older.
Of the people selected to participate, 5,308/7,265 people (73%) completed the screening
examination. All were then offered stereoscopic fundus photography. There were 4,396 people
who agreed to have photography and had at least one gradable photograph that were included in
this analysis. Further details have been previously described
Observation Procedure
History of cataract surgery was obtained by clinical exam. Those who had previous
cataract surgery (n=138) were asked to report their age at cataract surgery. Because we knew
their age at the baseline exam, the difference of the two ages provided us with the time since
cataract surgery. Photographs of the retina were reviewed in a masked fashion and graded for
signs of choroidal neovascularization, geographic atrophy, and signs of early AMD like drusen,
hyperpigmentation, or nongeographic atrophy. Also, during the clinical exam, AMD was

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