To the Editor The recent article by Cruickshanks et al,1 “Generational Differences in the 5-Year Incidence of Age-Related Macular Degeneration,” documents a 60% lower risk of age-related macular degeneration (AMD) in each subsequent birth cohort, which is in keeping with recent European studies showing a decline in the prevalence of AMD. I hypothesize that the phaseout of leaded gasoline in the 1970s and 1980s and the resultant dramatic decline in cumulative lifetime lead exposure may play a role in the observed decline in AMD incidence.
Fuller-Thomson E. Generational Differences in Lifetime Exposure to Lead and the Decreasing Incidence of Age-Related Macular Degeneration. JAMA Ophthalmol. 2018;136(8):958. doi:10.1001/jamaophthalmol.2018.2163
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