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Schick, Tina MD; Ersoy, Lebriz MD; Lechanteur, Yara T. E. MD; Saksens, Nicole T. M. MD; Hoyng, Carel B. MD, PhD; den Hollander, Anneke I. PhD; Kirchhof, Bernd MD; Fauser, Sascha MD

doi: 10.1097/IAE.0000000000000756
Original Study

Purpose: To evaluate effects of current and past sunlight exposure and iris color on early and late age-related macular degeneration (AMD).

Methods: Of 3,701 individuals from the EUGENDA database, 752 (20.3%) showed early AMD, 1,179 (31.9%) late AMD, and 1,770 (47.8%) were controls. Information about current and past sunlight exposure, former occupation type, subdivided in indoor working and outdoor working, and iris color were obtained by standardized interviewer-assisted questionnaires. Associations between environmental factors adjusted for age, gender, and smoking and early and late AMD were performed by multivariate regression analysis.

Results: Current sunlight exposure showed no association with early AMD or late AMD, but past sunlight exposure (≥8 hours outside daily) was significantly associated with early AMD (odds ratio: 5.54, 95% confidence interval 1.25–24.58, P = 0.02) and late AMD (odds ratio: 2.77, 95% confidence interval 1.25–6.16, P = 0.01). Outside working was found to be associated with late AMD (odds ratio: 2.57, 95% confidence interval 1.89–3.48, P = 1.58 × 10−9). No association was observed between iris color and early or late AMD.

Conclusion: Sunlight exposure during working life is an important risk factor for AMD, whereas sunlight exposure after retirement seems to have less influence on the disease development. Therefore, preventive measures, for example, wearing sunglasses to minimize sunlight exposure, should start early to prevent development of AMD later in life.

History of sunlight exposure including outdoor working is a risk factor for early and late stage age-related macular degeneration (AMD). Recent sunlight exposure and iris color are not associated with AMD.

*Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany; and

Department of Ophthalmology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.

Reprint requests: Sascha Fauser, MD, Department of Ophthalmology, University Hospital of Cologne, Kerpener Street 62, 50924 Cologne, Germany; e-mail:

None of the authors have any financial/conflicting interests to disclose.

© 2016 by Ophthalmic Communications Society, Inc.