FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2095258683> ?p ?o ?g. }

• W2095258683 endingPage "123" @default.
• W2095258683 startingPage "116" @default.
• W2095258683 abstract "Purpose: This study aimed to analyse the decline in visual acuity (VA) during normal ageing in two Scandinavian population samples of subjects aged ≥ 70 years and to study the age-specific decline in VA in eyes with early age-related maculopathy (ARM). Methods: We carried out a cross-sectional analysis of data pertaining to VA in the better eye in one population sample from Oulu (OU), Finland (aged 70–82 years) and a second population sample from Gothenburg (GG), Sweden (aged 82 or 88 years). The change in VA with age was evaluated in healthy eyes (OU, n = 119; GG, n = 40) and in eyes with early ARM (OU-ARM, n = 22; GG-ARM, n = 114) using linear regression or logistic regression. The results were compared with those of previous reports. Results: Our population samples showed a significant decrease with age in VA in healthy eyes in subjects aged ≥ 44 years using both statistical models. Comparisons with previous reports demonstrated a homogeneity in the decline in VA with age. On average, 0.3 logMAR are lost from middle age up to 88 years, presumably as a result of physiological ageing. In early ARM, the rate of age-specific decline in VA more than doubled and the prevalence of VA < 0.5 markedly increased. Conclusions: Visual acuity in healthy eyes declines with age from middle age onwards. The decrease in VA possibly accelerates in subjects aged > 70 years, although no significant evidence for this was found. An age-specific decline in VA is shown in eyes with early ARM. These results are important for the evaluation of age-specific treatment results. Several recent population-based studies have demonstrated a marked increase in visual impairment during ageing (Buch et al. 2001; Klein et al. 2006; Gunnlaugsdottir et al. 2008). The causes of age-related visual loss mainly concern pathological processes in the visual system. In addition, best corrected visual acuity (BCVA) has been shown to decrease in the course of ageing in subjects without observable ocular pathology (cf. Elliott et al. [1995] for a review). Less is known about the physiological ageing process in the elderly person after 70 years of age. Clarifying the age-specific effect of a pathological process requires that the physiological age-related decline in function is defined, especially if the pathological process is slow and of low degree. Early age-related maculopathy (ARM) is such a disease process that is common in the elderly population in Scandinavia (Laatikainen & Hirvelä 1995; Bergman et al. 2004; Buch et al. 2005; Björnsson et al. 2006). Few studies have presented the age-specific impact of early ARM on visual acuity (VA) in otherwise healthy eyes (Feigl et al. 2004) or following cataract surgery (Panchapakesan et al. 2004). One problem encountered when studying physiological ageing concerns the definition of a normal elderly population. In studies of VA during ageing, the criterion most commonly used is the absence of common age-associated ocular diseases at examination (i.e. the studies demand individuals with healthy eyes). Two studies with well-defined criteria for healthy eyes have described the decline in BCVA during ageing (Frisén & Frisén 1981; Elliott et al. 1995). However, data describing the changes after 75 years of age are few or lacking and subjects were not recruited from a population sample. The aim of the present study was primarily to analyse the decline in VA during the normal ageing process in two population samples and to focus on the ≥ 70 years age range. Our principle research question concerned whether the long trend in decline among normal subjects remains constant with age or accelerates in older people. Secondly, we studied the age-specific decline in VA in eyes with early ARM within the same populations. Preliminary results have been reported previously (Sjöstrand et al. 2004a, 2004b). We analysed BCVA in the better eye in subjects in two population samples, one drawn from Oulu, Finland (Hirvelä & Laatikainen 1995; Hirvelä et al. 1995; Laatikainen & Hirvelä 1995) and the other from Gothenburg, Sweden (Bergman et al. 1999, 2004). Two subgroups within these population samples, consisting of healthy eyes and eyes with early ARM, were used for the analysis of an age-related decline in BCVA. The subgroup of healthy eyes from the county of Oulu (OU) consisted of 119 eyes in 119 subjects out of a total of 476 co-operative subjects aged ≥ 70 years for whom data for BCVA in the better eye was obtained. This group had a median interpolated BCVA in the better eye of 0.97 and an age range of 70–82 years (Table 1). Of the fellow eyes, eight had signs of early ARM (hard drusen) and VA of 0.2–0.8, two had macular pucker, two had glaucoma, three had corneal opacities, two had amblyopia, and two eyes had markedly reduced VA (0.1 and 0.2), the cause of which is not known. The median BCVA of the remaining 100 fellow eyes was 0.90. The second cross-sectional dataset was drawn from the Gothenburg (GG) study population. In this population, 22 of 191 subjects examined at 82 years of age and 18 of 116 subjects examined at 88 years of age had eyes defined as healthy. The median interpolated BCVA of the better eyes was 0.80 (Table 1). In both studies, a healthy or normal eye was defined as an eye without any sign of ocular disease following a careful ophthalmological examination. The OU study included 500 subjects aged 70–95 years. In 478 subjects, gradable fundus photographs were available for at least one eye. No macular pathology was recorded in 219 eyes (46%). Of these, 119 had a clear lens and no other pathology, and thus were defined as healthy eyes (Hirvelä & Laatikainen 1995; Hirvelä et al. 1995). In the OU study, a clear lens accordant with the Lens Opacities Classification System (LOCS) II criteria (Chylack et al. 1989) was defined as NC 0–1, N 0–1, C 0–1 and P 0 (N = nuclear, C = cortical, P =posterior subcapsular cataract). In the GG study a careful slit-lamp examination determined the presence of a clear lens using criteria similar to those in the OU study. The OU population sample of otherwise healthy eyes with early ARM consisted of 22 eyes with clear lenses in 22 of 478 persons for whom gradable fundus photographs for least of one eye were available (Laatikainen & Hirvelä 1995). The corresponding population sample from GG included 88 of 191 individuals aged 82 years and 26 of 116 persons aged 88 years (Bergman et al. 2004). The median interpolated BCVA of the better eye with early ARM was 0.68 in the OU study and 0.72 in the GG study (Table 1). The definition of early ARM in the OU study included eyes with a clear lens as defined above, which showed definite clinically detectable pigment epithelial changes and/or drusen, including diffuse depigmentation of the macula but no signs of late ARM (Laatikainen & Hirvelä 1995). Eyes with late ARM (geographic atrophy or exudative age-related macular degeneration [AMD]) or cataract, aphakia or pseudophakia were excluded. Of the fellow eyes, one had exudative AMD and one had macular hole. All other fellow eyes had signs of early ARM and almost symmetrical VA compared with corresponding study eyes, and a median BCVA of 0.70. In the GG study, early ARM was similarly diagnosed in otherwise healthy eyes, which showed a clear lens with the presence of any drusen type except hard and indistinct, and with pigmentary abnormalities (areas of increased retinal pigment or hypopigmentation), but no signs of late ARM (Bergman et al. 2004). Best corrected VA in the OU study was tested at a distance of 6 m using a high-contrast portable E-chart (0.1–1.4) at a luminance of 180–200 cd/m2. In the GG study BCVA was tested at a distance of 5 m using a Monoyer–Granström letter chart (0.1–1.0) at a luminance of 500 cd/m2. For BCVA thresholds ≥ 0.6, one error was allowed in the OU study and two in the GG study (Bergman et al. 1999). Best corrected VA in the better eye was used in the analysis of BCVA as a function of age. In order to compare BCVA changes after 70 years of age in the two Scandinavian populations OU and GG, we analysed BCVA in 100 normal subjects (aged 11–75 years) from Frisén & Frisén (1981). Best corrected VA was tested at 5.3 m with a specially designed chart accepting one error per line (each line = 10 optotypes) and, in general, data for the right eye were included. Further data used for comparison were taken from Elliott et al. (1995) and comprised BCVA values in 187 subjects (aged 18–80 years) with normal healthy eyes. The measurements were collected with logMAR charts and optimal refractive correction. The original data in Elliott et al. (1995) actually contained 223 measurements, but it was not possible to obtain these data. However, data points could be reconstructed from Fig. 1 in Elliott et al. (1995) with permission from the authors, thereby losing 36 observations as a result of multiple representations. Scatterplot and fitted regression lines of logMAR versus age for FF1 and FF2 (data from Frisén & Frisén [1981]), and for E1 and E2 (data from Elliott et al. [1995]). A summary of the main characteristics of all groups considered in this paper is given in Table 1. Here, the data from Frisén & Frisén (1981) are divided into two groups, F1 and F2, as are the data from Elliott et al. (1995), E1 and E2. Reasons for this division are given below (linear regression for logMAR). Data in the groups GG and GG-ARM are censored, which means that observations are measured only in some intervals and observations outside the interval are counted but not measured (Kruskal & Tanur 1978). In this case VA values ≤ 0.9 are true values, but VA values ≥ 1.0 are recorded as 1.0. Statistical analysis was performed by treating VA data as either interval-scaled (continuous) by transforming VA values to the logarithm of the minimum angle of resolution, logMAR = 10log(1/VA), or ordinal-scaled (ranked) (Connover 1980). Notice that a linear increase of logMAR with age is equivalent to an exponential decrease in VA with age. (). In the former case data were analysed by using customary methods for linear regression and in the latter case by logistic regression methods. VA data were obtained by assigning a score for each patient using Snellen letters that are graded in difficulty and should thus, strictly speaking, be analysed by methods designed for ordinal-scale data (‘conservative standpoint’). However, it could be argued that VA data originate from an operational definition that reflects the true ability of the eye to see details and can thus be analysed as interval-scaled (‘liberal standpoint’). Data in the GG and GG-ARM subgroups were censored and, furthermore, collected at two ages only. This makes it impossible to make any inference about slope and intercept by using standard methods. It is still possible to compute rough estimates of intercept and slope (cf. Cramer [1957]) under certain assumptions (normal distribution around the linear regression line with constant variance), but p-values and confidence intervals (CIs) cannot be computed. The logistic approach is applicable also on the censored data in the GG and GG-ARM subgroups, provided that x ≤ 0.9. A detailed description of the statistical methods is given in the Appendix. All computations were made by utilizing the computer procedures proc glm (linear regression) and proc logistic (logistic regression) in sas, Version 9.1 (SAS Institute, Inc., Cary, NC, USA). Because of the wide age range in the data from Frisén & Frisén (1981), an attempt was first made to search for long trends. From a plot of the 9-point moving average of logMAR against age (not shown), it was decided to split the data into two parts, FF1 (11–43 years), where no long trend could be seen and logMAR fluctuates around − 0.09 (corresponding to VA = 1.23), and FF2 (44–75 years), which shows an increasing long trend. In a similar way the data from Elliott et al. (1995) were divided into two parts, E1 (11–43 years) and E2 (44–75 years). Here the cut-off at 43/44 years was also suggested by a plot of the moving averages. The intercepts (α) and slopes (β) of the fitted regression lines for FF1, FF2, E1 and E2 are shown in Table 2 and the regression lines are plotted together with the data in Fig. 1. Notice that the slopes in Table 2 of the FF1 and E1 groups are not significantly different from zero. The difference between the lines in F1 and F2, as well as the lines in E1 and E2, was highly significant as judged by the F-test (p = 0.003 and p = 0.005, respectively). By contrast, no significant difference was detected between the lines for FF1 and E1 (p = 0.18) and FF2 and E2 (p = 0.37). In fact, the fitted lines in FF2 and E2 were almost identical. From the value of β describing the annual logMAR change in Table 2 for FF2 and E2, we can conclude that the yearly relative change in mean VA was − 0.8% (95% CI − 1.2 to − 0.3). The slope β in Table 2 for OU (70–82 years) was larger than for FF2 and E2 and corresponds to a yearly relative change in mean VA of − 1.7% (95% CI − 3.1 to − 0.3). However, the hypothesis of identical regression lines for the groups FF2 and OU was far from being rejected by the F-test (p = 0.84). Rough estimates of α and β for the censored data in GG (82 and 88 years) were α = − 1.60 and β = 0.0193. This slope is, in turn, larger than the slope for the group OU and might indicate an accelerating increase in logMAR (i.e. a decrease in VA) at higher ages. Unfortunately, this was not possible to test because of the quality of data (cf. Statistical methods). The above results suggest that VA in healthy eyes generally remains constant up to 43 years of age and that there is a yearly relative decrease in VA of about 1% from 44 to 80 years. It is possible that the decrease in VA accelerates in subjects aged > 70 years, but no significant evidence for this could be found in the present study. The slope β was nearly three times higher in the OU-ARM than the OU group (Table 2). This corresponds to a yearly relative change in mean VA of − 4.7% (95% CI − 8.4 to − 0.7) in the OU-ARM subgroup compared with − 1.7% in the OU subgroup. The difference between the fitted regression lines is clearly visible in Fig. 2. The hypothesis that identical lines might apply in the OU and OU-ARM subgroups was strongly rejected by the F-test (p < 0.0001). A descriptive summary of the difference between changes in VA with age in healthy eyes (OU and GG) and eyes with early ARM (OU-ARM) is shown in Fig. 3. Rough estimates of α and β for the censored data in GG-ARM (82 years, 88 years) were α = − 2.39 and β = 0.023. Scatterplot and fitted regression lines of logMAR versus age for the OU (Oulu population) and OU-ARM (Oulu population with early age-related maculopathy) groups. Linear regression lines, extrapolated to 82 years, for FF2 (data from Frisén & Frisén [1981]) and E2 (data from Elliott et al. [1995]) are plotted for comparison. Scatterplot of mean logMAR (± 95% confidence interval) versus age for the OU (Oulu population) (year bins: 70–72, 73–75, 76–78 and 79–82 years) and GG (Gothenburg population) (mean at 82 and 88 years, respectively) samples. The linear regression line for OU-ARM (Oulu population with early age-related maculopathy) is plotted for comparison. Table 3 illustrates the results of the logistic regression in Equation (1) (cf. Appendix). Because of the different ranges for VA in the groups (cf. Table 1), it was not possible to use the same value for x for all groups. βx in the groups FF1 and E1 was not significantly different from zero, indicating that no long trend in VA is present before the age of 43 years. In the later age ranges, slightly < 50% of subjects have VA ≤ 1.2. In the FF2 and E2 groups there was, by contrast, a significant increase in the proportion of subjects with VA ≤ 1.2 with increasing age, which rose to nearly 90% in subjects aged 75 years. The difference between the logistic relations in FF1 and FF2, as well as the logistic relations in E1 and E2, was significant as judged by the chi-square test (p = 0.022, and p = 0.015, respectively). No significant difference was obtained between the relations in FF1 and E1 (p = 0.10) or FF2 and E2 (p = 0.76). In addition, in the OU and GG groups there was a significant trend towards an increase with age in the proportion of subjects with VA ≤ 0.9 and VA ≤ 0.7, respectively. The difference between the logistic relations in OU and GG was tested for three values of x and in no case was a significant difference obtained (p = 0.41 for x = 0.7, p = 0.68 for x = 0.8, p = 0.79 for x = 0.9). Results of the logistic regression in the OU-ARM and GG-ARM subgroups are shown in Table 4 for x = 0.7, 0.8 and 0.9, respectively. For these values of x the proportion of eyes with VA ≤ x was higher in the OU-ARM than in the GG-ARM subgroup. Chi-square tests (cf. Materials and Methods) showed that the difference between the logistic relations in the two groups was significant for x = 0.8 (p = 0.013) and x = 0.9 (p = 0.030), but not for x = 0.7 (p = 0.17). The difference between the two logistic relations in the OU-ARM and OU subgroups was significant (p = 0.003). An even sharper significance was obtained for x = 0.7 (p =0.0004) and x = 0.8 (p = 0.0004). The proportion with VA ≤ 0.9 was higher in the OU-ARM than the OU group for all ages and was especially substantial in the 75–85-year age range (e.g. 96% of subjects in OU-ARM had VA ≤ 0.9 at 80 years, compared with just 56% in the OU group). A similar pattern was obtained when comparing GG-ARM and GG subgroup results. The differences between the logistic curves were now smaller, but still significant (p =0.048 for x = 0.7, p = 0.014 for x = 0.8, p = 0.001 for x = 0.9). Bilateral visual impairment defined as BCVA < 0.5 in the better eye (van Leeuwen et al. 2007), is presented in Table 1. In the OU and GG groups of healthy eyes, the percentages of eyes with BCVA < 0.5 were 1% and 2%, respectively, rising to 18% and 12%, respectively, in the corresponding early ARM groups. Our statistical analyses of BCVA in healthy eyes in two elderly Scandinavian population samples show a significant positive long trend of logMAR (i.e. a continuous decline in VA in the better eye between the ages of 70 and 88 years. The linear rate of change (in terms of logMAR) in the OU sample was − 1.7% per year or 0.075 logMAR per decade, representing a relative decrease of approximately 1 logMAR line (0.1) per 13.5 years. The comparison of the OU sample with the sample aged > 43 years (FF2) from a previous clinical study (Frisén & Frisén 1981) and the population sample (GG) from Gothenburg demonstrated that the samples are homogenous from 44 to 82 years; thus a VA decline that accelerates more rapidly than linearly (in terms of logMAR) with age could not be proved. Although no significant heterogeneity was detected between the FF2 and OU datasets, the trend coefficient was much smaller for FF2 (44–75 years) than for OU (70–82 years) and it is possible that larger samples might reveal a development of logMAR that accelerates more rapidly than linearly with increasing age. In total, approximately 0.3 logMAR or three lines are lost from middle age to 88 years of age. If the regression models used in our study are applied to the data for healthy eyes reported by Elliott et al. (1995), the pattern and magnitude of VA change is almost identical to the result of the data analysis reported by Frisén & Frisén (1981). The results of these two previous studies of VA change with age (Frisén & Frisén 1981; Elliott et al. 1995) suggest that, on the whole, VA in healthy eyes remains constant up to 43 years of age and that there is a yearly relative decrease in VA of about 1% from 44 to 80 years. A similar non-linear ageing process, in which threshold values remain close to constant up to 40 years of age and decline thereafter, has recently been described for differential luminance sensitivity of the visual field (Hermann et al. 2008). The finding of an identical breaking point at 43/44 years by analysis of moving averages in both Frisén & Frisén (1981) and Elliott et al. (1995) is notable. In their original studies Frisén & Frisén (1981) found a maximum at about 25 years using peak-searching regression and Elliott et al. (1995) found a peak at 29 years using bilinear regression. The two studies identified the breaking points by using statistical methods based on specific assumptions, presupposing that there is one maximal VA value in Frisén & Frisén (1981) and normality distribution around the regression lines with constant variance in Elliott et al. (1995). The moving average procedure used in the present study is free from assumptions. The different breaking points found in the studies may simply reflect the use of different techniques. The decline in VA as a function of ageing in the present study is more marked than that calculated for age-related loss of retinal ganglion cells based on results of perimetry outside the fovea or optic nerve axon counts in the literature (Frisén 1991; Harwerth & Wheat 2008). A recalculation of the decline rates derived from these studies using our bilinear model (in terms of logMAR) with onset of loss after 40 years of age makes the estimated losses more comparable. This obvious acuity decline from the fifth decade of life in eyes without pathological findings probably reflects changes in several components of the fovea or central visual pathways. No clear structural correlate to this increasing photopic acuity deficit during ageing, however, has been described in available morphological studies (Curcio et al. 1993; see Spear 1993 for a review). Despite the calculated loss of 0.1 logMAR per 13.5 years after 70 years of age, the majority of healthy eyes (98%) maintain VA ≥ 0.5 up to 82–88 years (Table 1). The progressive decline in VA with age is also reflected in studies of age-specific acuity following uncomplicated cataract surgery in eyes without comorbidities (Westcott et al. 2000; Panchapakesan et al. 2004). The latter authors report VA < 0.5 in 5% and 11% of subjects at 70–79 and ≥ 80 years, respectively. Another factor to consider in evaluating VA decline with age is the fact that the average optical performance of healthy eyes declines progressively with age (Guirao et al. 1999; Alió et al. 2005). However, the fact that photopic VA is relatively insensitive to minor variations of retinal image quality (Pesudovs et al. 2004; Applegate et al. 2006) makes it difficult to attribute the VA decline with age to increased aberrations. Straylight disability also increases with age in the healthy eye, but VA and straylight have been shown to vary quite independently (van den Berg et al. 2007). Furthermore, displacement threshold hyperacuity, which seems unaffected by optical changes, reduces in sensitivity with increasing age, like VA (Elliott et al. 1989), indicating that changes in neural components are the predominant causes. The prevalence of visual impairment, defined as VA < 0.5 in our two elderly population samples, increased markedly among eyes with early ARM without other ocular morbidities (Table 1), as previously described by Laatikainen & Hirvelä (1995) for the OU population. Klein et al. (1995) described an increase in risk for impaired vision for eyes with early ARM of 2.1 times that for eyes without early ARM, but the relationship was not statistically significant. Our prevalences of 12% and 18% (Table 1) of mild visual impairment in subjects with early ARM are within the range reported for a general Scandinavian or European population aged ≥ 75 years, including all eye diseases (Klaver et al. 1998; Buch et al. 2001). This finding indicates that early ARM, which has a prevalence of almost 50% in older Europeans (Augood et al. 2006), is a notable cause of mild visual impairment in an elderly population. In a previous study from Gothenburg (Bergman et al. 2004), the prevalences of mild visual impairment in eyes with early ARM were 24% and 53% at the ages of 95 and 97 years, respectively. In the present study we show that the age-specific rate of change in VA decline is up to three times higher in otherwise healthy eyes with early ARM. The higher rate of decline observed in the OU group compared with the GG group may be explained by differences in the two cohorts that reflect differences in birth cohorts, diet or general health. In a study of central visual function in subjects aged 70 years, Feigl et al. (2004) demonstrated an average reduction in high-contrast VA of 0.15 logMAR in eyes with early ARM compared with controls. The regression analyses showed a significant linear increase in logMAR with age (corresponding to an exponential decline in VA) for all groups considered, with the exception of the groups aged 11–43 years. Both approaches supported the hypothesis that in healthy eyes VA remains stable up to 43 years of age and decreases from 44 years of age. The evidence for this was stronger in the linear regression approach, as judged by the p-values. The two approaches led to the same conclusions when comparing VA in the OU-ARM and OU groups, but the evidence based on linear regression was stronger. From a methodological point of view it is interesting that the two approaches led to similar conclusions, suggesting that linear regression with logMAR as a dependent variable is an adequate statistical method for analysing VA data. The use of population samples avoids selection bias among healthy eyes and is important in the comparison of eyes with and without early ARM. However, the use of the OU and GG population studies with primary focus on epidemiology makes the criteria for VA testing and clinical diagnosis less stringent. The definition used for healthy eyes was absence of disease as observed at a thorough eye examination or in fundus photography. Subclinical disease, however, cannot be ruled out and we still lack understanding of the physiological basis for visual decline during ageing. It is obvious that fluorescein angiography (FA) would have revealed more subtle changes than careful direct ophthalmoscopy or biomicroscopy with a 90-D Volk lens and standard fundus photography, but FA cannot be used in large epidemiological studies; our populations included 500 persons aged ≥ 70 years in Oulu and around 300 in Gothenburg. A separate analysis was performed to evaluate whether the higher rate of VA decline in the better eye in the OU-ARM subgroup might reflect the retinal status of the fellow eye. No indications were found for rapidly progressing eye disease in this group of patients as > 90% of these fellow eyes had early ARM and the majority showed almost symmetrical VA compared with study eyes. A similar analysis of the possible influence of VA decline in the OU group showed that 84% had healthy fellow eyes, with a median BCVA within the range of study eyes. The VA measurements included were obtained by a cross-sectional design and our analyses are therefore restricted to differences in various age groups. Information about the subjects’ previous visual function is needed to estimate true changes with age. The fact that data in the GG and GG-ARM groups were censored (observations of VA ≥ 1.0 are lacking) limited the use of these data to logistic analysis of VA ≤ 0.9. A general problem in studies of normal vision in ageing concerns the fact that the percentage of healthy eyes within a population decreases rapidly after 70 years of age. In our study, the healthy eyes (with no pathological findings) represented 35% of the younger population sample from Oulu (OU) and 13% of the older sample from Gothenburg (GG). A previous study (Bergman et al. 2004) found healthy eyes in < 1% of subjects aged 95 or 97 years. This rapidly decreasing number of healthy eyes creates an obstacle to the study of physiological ageing in the very elderly population. In summary, our study of two Scandinavian populations demonstrates that VA continuously declines during ageing after the age of 70 years in eyes without pathological findings. The rate of VA decline is accelerated in eyes with early ARM as the only observed pathology. The authors thank Birgitta Bergman, Lars Frisén and David B. Elliott for allowing the use of their published data. This research was supported by grants from the Gothenburg Medical Society." @default.
• W2095258683 created "2016-06-24" @default.
• W2095258683 creator A5006495590 @default.
• W2095258683 creator A5009492282 @default.
• W2095258683 creator A5025608767 @default.
• W2095258683 creator A5056308950 @default.
• W2095258683 creator A5091626062 @default.
• W2095258683 date "2011-02-23" @default.
• W2095258683 modified "2023-10-07" @default.
• W2095258683 title "The decline in visual acuity in elderly people with healthy eyes or eyes with early age-related maculopathy in two Scandinavian population samples" @default.
• W2095258683 cites W1205745193 @default.
• W2095258683 cites W1528122679 @default.
• W2095258683 cites W1966502730 @default.
• W2095258683 cites W1981300773 @default.
• W2095258683 cites W1984790912 @default.
• W2095258683 cites W1988245456 @default.
• W2095258683 cites W2003586642 @default.
• W2095258683 cites W2011538376 @default.
• W2095258683 cites W2022463667 @default.
• W2095258683 cites W2027141805 @default.
• W2095258683 cites W2035246559 @default.
• W2095258683 cites W2035637080 @default.
• W2095258683 cites W2056764776 @default.
• W2095258683 cites W2059033740 @default.
• W2095258683 cites W2067867204 @default.
• W2095258683 cites W2084250188 @default.
• W2095258683 cites W2088432960 @default.
• W2095258683 cites W2090587102 @default.
• W2095258683 cites W2092197452 @default.
• W2095258683 cites W2095781537 @default.
• W2095258683 cites W2098493299 @default.
• W2095258683 cites W2116830724 @default.
• W2095258683 cites W2123921337 @default.
• W2095258683 cites W2148070213 @default.
• W2095258683 cites W2148138551 @default.
• W2095258683 cites W2148889729 @default.
• W2095258683 cites W2156834139 @default.
• W2095258683 cites W2886359584 @default.
• W2095258683 doi "https://doi.org/10.1111/j.1755-3768.2009.01653.x" @default.
• W2095258683 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/19845558" @default.
• W2095258683 hasPublicationYear "2011" @default.
• W2095258683 type Work @default.
• W2095258683 sameAs 2095258683 @default.
• W2095258683 citedByCount "33" @default.
• W2095258683 countsByYear W20952586832012 @default.
• W2095258683 countsByYear W20952586832013 @default.
• W2095258683 countsByYear W20952586832014 @default.
• W2095258683 countsByYear W20952586832015 @default.
• W2095258683 countsByYear W20952586832016 @default.
• W2095258683 countsByYear W20952586832017 @default.
• W2095258683 countsByYear W20952586832018 @default.
• W2095258683 countsByYear W20952586832019 @default.
• W2095258683 countsByYear W20952586832020 @default.
• W2095258683 countsByYear W20952586832022 @default.
• W2095258683 countsByYear W20952586832023 @default.
• W2095258683 crossrefType "journal-article" @default.
• W2095258683 hasAuthorship W2095258683A5006495590 @default.
• W2095258683 hasAuthorship W2095258683A5009492282 @default.
• W2095258683 hasAuthorship W2095258683A5025608767 @default.
• W2095258683 hasAuthorship W2095258683A5056308950 @default.
• W2095258683 hasAuthorship W2095258683A5091626062 @default.
• W2095258683 hasConcept C118487528 @default.
• W2095258683 hasConcept C119767625 @default.
• W2095258683 hasConcept C134018914 @default.
• W2095258683 hasConcept C2776403814 @default.
• W2095258683 hasConcept C2778257484 @default.
• W2095258683 hasConcept C2778313320 @default.
• W2095258683 hasConcept C2781116099 @default.
• W2095258683 hasConcept C2908861002 @default.
• W2095258683 hasConcept C3018697994 @default.
• W2095258683 hasConcept C555293320 @default.
• W2095258683 hasConcept C71924100 @default.
• W2095258683 hasConcept C74909509 @default.
• W2095258683 hasConceptScore W2095258683C118487528 @default.
• W2095258683 hasConceptScore W2095258683C119767625 @default.
• W2095258683 hasConceptScore W2095258683C134018914 @default.
• W2095258683 hasConceptScore W2095258683C2776403814 @default.
• W2095258683 hasConceptScore W2095258683C2778257484 @default.
• W2095258683 hasConceptScore W2095258683C2778313320 @default.
• W2095258683 hasConceptScore W2095258683C2781116099 @default.
• W2095258683 hasConceptScore W2095258683C2908861002 @default.
• W2095258683 hasConceptScore W2095258683C3018697994 @default.
• W2095258683 hasConceptScore W2095258683C555293320 @default.
• W2095258683 hasConceptScore W2095258683C71924100 @default.
• W2095258683 hasConceptScore W2095258683C74909509 @default.
• W2095258683 hasIssue "2" @default.
• W2095258683 hasLocation W20952586831 @default.
• W2095258683 hasLocation W20952586832 @default.
• W2095258683 hasOpenAccess W2095258683 @default.
• W2095258683 hasPrimaryLocation W20952586831 @default.
• W2095258683 hasRelatedWork W163105695 @default.
• W2095258683 hasRelatedWork W1789818221 @default.
• W2095258683 hasRelatedWork W1990217299 @default.
• W2095258683 hasRelatedWork W2009706585 @default.
• W2095258683 hasRelatedWork W2023857471 @default.
• W2095258683 hasRelatedWork W2027716003 @default.
• W2095258683 hasRelatedWork W2090818994 @default.
• W2095258683 hasRelatedWork W2308272655 @default.

• next