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J. Donofrio, S. Fraser–Bell, J. Wu, M. Knudtson, R. Klein, R. Varma; Bilaterality of AMD in Latinos and Non–Hispanic Whites: The Los Angeles Latino Eye Study (LALES) and The Beaver Dam Eye Study (BDES). . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3039.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To present age– and sex–specific estimates of bilateral age–related macular degeneration (AMD) in Latinos in Los Angeles, and non–Hispanic whites (NHWs) in Beaver Dam. Methods: The LALES cohort consisted of Latinos aged 40+ years and the BDES cohort of NHWs aged 43+ years. Stereoscopic fundus photographs from both studies were graded at the same center for early AMD (drusen, retinal pigment abnormalities) and advanced AMD. Age–specific bilaterality rates were determined and compared. Results: 536 Latinos and 930 NHWs with good quality photos in both eyes and any AMD in either eye were included. Of these persons, any AMD was bilateral in 23% in Latinos and in 39% in NHWs. There were 515 Latinos and 855 NHWs with early AMD. Of these persons, early AMD was bilateral in 21% of Latinos and 34% of NHWs. In Latinos, the age–specific bilaterality of early AMD (among Latinos with early AMD) increased from 16% in those aged 40–49 years to 43% in those 80 years and older (p–value for trend <0.0001), indistinct soft drusen from 12% to 47% (p<0.0001), and pigmentary abnormalities from 14% to 41% (p<0.001), respectively. In NHWs, the age–specific bilaterality of early AMD increased from 17% in those aged 40–49 years to 53% in those 80 years and older (p<0.0001), indistinct soft drusen from 18% to 37% (p<0.0001), and pigmentary abnormalities from 18% to 59% (p<0.0001), respectively. There were 23 Latinos and 75 NHWs with advanced AMD. Of these persons, advanced AMD was bilateral in 48% of Latinos and in 43% of NHWs. Bilateral advanced AMD (among those with advanced AMD) increased in Latinos from 33% in 60–69 year–olds to 67% of those aged 80 years and older (p=0.03), and exudative AMD from 50% to 71% (p=0.06), respectively. Bilateral advanced AMD (among NHWs with AMD) increased from 9% in 60–69 year–olds to 69% of those 80 years and older (p<0.0001), and exudative AMD from 11% to 45% (p=0.09), respectively. No significant differences in the presence of bilateral AMD lesions were observed in males and females with AMD in either cohort. Conclusions: Despite a general clinical impression that AMD is a bilateral disease, our data suggest that a majority of Latinos and NHWs with AMD have unilateral disease. However, older persons with AMD (both Latinos and NHWs) were more likely to have bilateral AMD compared to younger persons with AMD. While NHWs appear to have a higher bilaterality rate of early AMD, Latinos have a higher bilaterality of advanced AMD. The reason for this difference needs further study.
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