Citation: Mao F, Yang X, Yang K, et al. Six-year incidence and risk factors for age-related macular degeneration in a rural Chinese population: the Handan Eye Study. Invest Ophthalmol Vis Sci. 2019;60:4966-4971. https://doi.org/ 10.1167/iovs.19-27325 PURPOSE.To describe the 6-year incidence of early and late age-related macular degeneration (AMD) and its associated factors in a representative large rural Chinese population. METHODS. A population-based longitudinal study was conducted in ruralChina from 2006 to 2007. In total, 6830 persons aged 30 years or older participated in the study. The 6-year follow-up study was performed between 2012 and 2013. The modified Wisconsin Age-Related Maculopathy Grading System (WARMGS) protocol in the Blue Mountains Eye Study was used as the AMD grading standard.RESULTS. Excluding 509 deceased subjects, 5394 (follow-up rate 85.3%) completed the followup. Among them, 5048 participants had gradable photographs of at least one eye at both examinations. The incidence of early and late AMD over 6 years was 4.2% (95% CI, 3.8%-4.7%) and 0.2% (95% CI, 0.2%-0.3%), respectively. In the multivariable analysis, per-year increase in age (P < 0.001; OR ¼ 1.06; 95% CI, 1.04-1.07), male sex (P ¼ 0.006; OR ¼ 0.64; 95% CI, 0.47-0.88), and per-millimeter increase in axial length (P ¼ 0.010; OR ¼ 0.78; 95% CI, 0.63-0.94) at baseline were significantly associated with incident early AMD. Early AMD was not associated with systolic blood pressure, diastolic blood pressure, hypertension, diabetes, history of stroke, history of heart disease, body mass index, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglycerides, smoking status, refractive error, or corneal curvature radius. There were too few cases of late AMD for a valid statistical analysis of the risk factors.CONCLUSIONS. The incidence of early and late AMD over 6 years in a rural Chinese population was 4.2% (95% CI, 3.8%-4.7%) and 0.2% (95% CI, 0.2%-0.3%), respectively. Age, sex, and axial length are relevant risk factors for early AMD in rural China.

In patients with unilateral ISCNV, intravitreal ranibizumab therapy was associated with a thinning of an abnormally thick subfoveal choroid, marginally in association with a parallel decrease in retinal foveal thickness. It remained elusive whether the choroidal thinning was due to a direct pharmacological effect of ranibizumab or whether it was secondary due to the foveal retinal thinning. In view of the significant differences in SFCT between affected eyes and unaffected contralateral eyes at baseline and in view of the significant therapy-associated decrease in SFCT, the potential role of SFCT as an additional marker for the diagnosis and follow-up of ISCNV and other neovascular maculopathies may be examined in future studies.

In class incremental learning (CIL) a model must learn new classes in a sequential manner without forgetting old ones. However, conventional CIL methods consider a balanced distribution for each new task, which ignores the prevalence of long-tailed distributions in the real world. In this work we propose two long-tailed CIL scenarios, which we term ordered and shuffled LT-CIL. Ordered LT-CIL considers the scenario where we learn from head classes collected with more samples than tail classes which have few. Shuffled LT-CIL, on the other hand, assumes a completely random long-tailed distribution for each task. We systematically evaluate existing methods in both LT-CIL scenarios and demonstrate very different behaviors compared to conventional CIL scenarios. Additionally, we propose a two-stage learning baseline with a learnable weight scaling layer for reducing the bias caused by long-tailed distribution in LT-CIL and which in turn also improves the performance of conventional CIL due to the limited exemplars. Our results demonstrate the superior performance (up to 6.44 points in average incremental accuracy) of our approach on CIFAR-100 and ImageNet-Subset. The code is available at https://github.com/xialeiliu/Long-Tailed-CIL.

Purpose: To evaluate choroidal thickness in patients with idiopathic choroidal neovascularization. Methods: The observational case series study included patients who were consecutively diagnosed with idiopathic unilateral choroidal neovascularization as demonstrated by ophthalmoscopy, fluorescein angiography and enhanced depth imaging optical coherence tomography (EDI-OCT). Using EDI-OCT, choroidal thickness was measured at the fovea and at locations in a distance of 500, 1,000 and 1,500 μm temporal and nasal to the fovea. Results: Mean subfoveal choroidal thickness was significantly (p = 0.002) thicker in the study group than in the control group (357 ± 99 vs. 316 ± 83 μm). In a parallel manner, the differences between the study group and the control group in choroidal thickness were significant for all other measurement points, except for the examination at 1,500 μm nasal to the fovea (p = 0.09). The results remained unchanged after adjusting for axial length and age. Conclusions: Idiopathic unilateral choroidal neovascularization is associated with a thickening of the choroid.