Epidemiology: the PAMDI study

The PAMDI is an epidemiological study aimed at estimating the prevalence and the risk factors associated with AMD within an Italian population and to analyse the differences between urban and rural communities. The study was conducted among elderly residents in North-Eastern Italy. The participants were divided into urban and rural groups according to their residence in the city of Padua or in the villages of Teolo and Torreglia, respectively. The grading of the fundus photographs was performed according to the International Classification of Age-Related Maculopathies.
A total of 1,162 subjects, aged 61 years and older, were invited to participate in the study, 885 of whom adhered and 845 were eligible for fundus photo grading. It was estimated that 62.7% of the entire population had AMD (drusen 63-124 ?=?48,3%; drusen ?125 ?m?=?10,4%; Advanced DMLE 4.1%). Theage as a risk factor for drusen ?125 ?m and advanced AMD. The rural group compared to the urban one reported a higher risk to develop broad drusen, even when adjusting for gender and age.
The results of the PAMDI study confirmed, among other things, the protective effect against AMD of a diet rich in antioxidants and the potential toxic effect of exposure to sunlight. The two starting hypotheses of the study, that 1) 'living in a rural environment' or 2) 'belonging to a Mediterranean basin population' may protect against the intermediate stages of the disease, were not validated by the data collected.