Age-Related Maculopathy (ARM) in remote Southern Italy

Purpose. By estimating the prevalence of age-related maculopathy in a remote community in Southern Italy, we investigate the possibility that ARM may be due to environmental exposures, ubiquitous in industrialised society, but rare in communities isolated from modern life. Methods. All residents of Salandra (a small isolated community in the Province of Matera in southern Italy) older than 59yrs were invited to participate. ARM was assessed by both fundus biomicroscopy and 30° stereo photography. Consumption of home grown products and industry processed and packaged foods was assessed by interview. Migration rates and the degree of genetic isolation were computed using a model which fits the genetic structure of a finite population based on the community's surname frequency distribution. Results. Of 576 eligible subjects, 366 (64%) were seen and 354 (97%) had clinical or photographic assessment for advanced ARM. The overall prevalence of advanced ARM was 1.1%. Drusen larger than 50 microns and more numerous than 10 were found in 4.5% of subjects. Thirty non attenders were examined at home who were older(p<0.05) and more infirm, but had a similar prevalence of drusen. A high degree of marriage within the community, a low immigration rate (mutation rate ν = 0,23), and a degree of isolation higher than in areas with rapid industrial growth was found (coefficient of genetic isolation α=115.21). Consumption of industrial food products among participants was infrequent and limited to few subjects and items. Conclusion. The prevalence of ARM in this community is lower than elsewhere in the western world.