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Markedly lower rates of age-related macular degeneration in Malta compared to European countries : results from the Malta eye study, indicating possible divergent genetic ancestry?

2025-11-06T15:17:30Z

Title: Markedly lower rates of age-related macular degeneration in Malta compared to European countries : results from the Malta eye study, indicating possible divergent genetic ancestry? Authors: Agius, David; Mamo, Julian J.; Calleja, Neville; Cassar, Daniel; Marku, Xeniya; Nappa, Maria Christina; Zammit, Michaela; Pace, Maria Elena; Carbonaro, Francis Abstract: Purpose: To estimate the prevalence of age-related macular degeneration (ARMD) in a nationally representative sample of older adults from Malta, evaluate associations with established risk factors, and compare rates with those reported in other European populations, where substantial variation has been observed. Patients and Methods: A population-based cross-sectional study was conducted involving 1794 participants aged 50–80 years from Malta (1% of the represented population), recruited as part of The Malta Eye Study. Standardized ophthalmic examinations were performed, including retinal imaging graded for ARMD according to Age-Related Eye Disease Study criteria and optical coherence tomography scans. Data on demographics, medical history, behavioural risk factors, and ocular characteristics were collected via structured questionnaires. Associations were assessed using multivariable logistic regression. DNA samples were also collected for future genetic analyses. Results: The overall prevalence of ARMD was 6.5% (95% CI 5.4–7.8%), with early ARMD accounting for 5.6% (95% CI 4.6–6.7%) and late ARMD for 0.4% (95% CI 0.2–0.8%). Multivariate analysis showed that ARMD prevalence increased significantly with age (OR per year 1.08; 95% CI 1.05–1.11, p<0.001) and in the male sex (OR 1.57; 95% CI 1.01–2.44, p=0.043). The other traditional ARMD risk factors did not show significant associations in this cohort. Compared to other European populations, ARMD prevalence was notably lower. Conclusion: This study reports a relatively low prevalence of ARMD compared to other European settings, with age and male sex emerging as the only significant risk factors. The absence of association with other traditional risk factors may reflect underlying genetic differences or distinct gene–environment interactions. As DNA samples were collected, further investigation incorporating genetic data is warranted to better understand ARMD susceptibility in this population.

10.Y.1 PechaKucha : innovating the oral health workforce : pathways to universal health coverage

2025-11-06T15:10:27Z

Title: 10.Y.1 PechaKucha : innovating the oral health workforce : pathways to universal health coverage Authors: Vassallo, Pauline; Calleja, Neville Abstract: The Bangkok Declaration emphasizes the urgent need for innovative approaches to strengthen health systems and achieve universal health coverage (UHC). Within this framework, the oral health workforce plays a pivotal role in enhancing access to oral health care and ensuring equitable and comprehensive care for all populations. [extract]

The population characteristics and prevalence of visual impairment in a Southern European population

2025-11-06T14:58:20Z

Title: The population characteristics and prevalence of visual impairment in a Southern European population Authors: Agius, David; Mamo, Julian; Calleja, Neville; Cassar, Daniel; Marku, Xeniya; Nappa, Maria Christina; Zammit, Michaela; Pace, Maria Elena; Carbonaro, Francis Abstract: Purpose: To describe the population characteristics, prevalence, and causes of visual impairment in Maltese adults aged 50–80 years. Methods: The Malta Eye Study invited 4,006 random adults aged 50–80 for eye exams and interviews at the Malta and Gozo state hospitals (September 2021–July 2024). Tests included visual acuity, refraction, anthropometry, clinical measurements, tonometry, slit-lamp and dilated fundus exams, retinal imaging, and cognitive screening. Interviews covered sociodemographic, medical, ocular, and medication histories. Results: A representative sample of 1,794 individuals (44.8% turnout) were assessed. Visual impairment in either eye was found in 23.9% (95%CI 21.9%–25.9%), and bilateral impairment in 6.0% (95%CI 4.9%–7.2%). The most common causes in either eye were uncorrected/undercorrected refractive error (12.3%), amblyopia (5.0%), cataract (3.8%), pathological myopia (1.3%), diabetic retinopathy (0.8%), age-related macular degeneration (0.6%), and glaucoma (0.4%). Predictors of visual impairment included older age, lower education, diabetes requiring insulin and tablets, and dementia. Protective factors were sunglasses use and angiotensin receptor blocker therapy. Conclusions: Although overall visual impairment rates are favourable, this study highlights the need to strengthen screening and treatment services for avoidable causes, particularly by improving public optometry access, among older adults, socioeconomically vulnerable groups, and those with poorly controlled diabetes.

Analysis of caesarean section rates in Malta using the Robson ten-group classification system

2025-11-06T14:07:58Z

Title: Analysis of caesarean section rates in Malta using the Robson ten-group classification system Authors: Sant Fournier, Kristina; Gatt, Miriam; Calleja, Neville Abstract: Background: Caesarean section (CS) rates continue to rise globally. In Malta, the rate of caesarean deliveries has increased by eight percentage points over the past two decades. The World Health Organization recommends the use of the Robson classification as a global standard for monitoring and auditing CS. This study aimed to examine CS rates in the Maltese Islands across two time periods using the Robson classification. Methods: A retrospective, registry-based study was conducted covering all deliveries between 2009-2013 and 2019- 2023. Women undergoing childbirth in Malta and Gozo were allocated to one of the 10 Robson groups. Changes in overall CS rates and contributions by Robson group between the two periods were analysed using significance tests. Indications for CS were analysed for 2019-2023. Results: A total of 42,585 deliveries were analysed across both periods. Despite more advanced maternal age and a higher proportion of non-Maltese mothers over the time periods, the CS rate remained stable (31.9% in 2009-2013; 32.6% in 2019-2023). Contributions to the overall CS rate of Robson groups 5 (previous CS), 6 and 7 (breech) increased significantly, whilst contributions of groups 1 (nullipara, spontaneous labour), 2 (nullipara, induction/pre-labour CS), 8 (multiple pregnancies), and 10 (preterm) decreased significantly between study periods. The top contributors remained Robson groups 5 and 2, followed by 1. Conclusions: The Robson classification allows identification of the obstetric populations driving CS use. Our study findings provide a starting point for auditing of obstetric practices with a view to reducing CS rates.