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Bruce Burkemper; Risk factors for prevalent early AMD and associated retinal lesions: The Chinese American Eye Study.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):14.
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© 2017 Association for Research in Vision and Ophthalmology.
To assess associations between early age-related macular degeneration (AMD) and multiple factors comprising a novel conceptual model of AMD risk in a population of Chinese Americans.
A population-based study of 4582 Chinese Americans aged 50 years and older residing in Monterey Park, California. Participants completed a comprehensive eye exam including stereoscopic fundus photography and ocular biometric measurements. Fundus images were graded using a modified version of the Wisconsin Age-Related Maculopathy Grading System.
4172 participants (72% of those eligible) had fundus photographs gradable for AMD. Early AMD was present in 376/8106 eyes (4.6%); late AMD was present in 17/8106 (0.2%). Shorter axial length (AL), male gender, increasing age, and family history of AMD were associated with prevalent early AMD and with retinal lesions characteristic of AMD. Eyes in the 1st quartile of AL (<22.99 mm) were 2.07 times as likely to have early AMD relative to eyes in the 4st quartile (>=24.53 mm) (95% confidence interval (CI) 1.45-2.95). Each 1 mm decrease in AL corresponded to an average increase in early AMD risk of 29% (OR 1.29, 95% CI 1.18-1.42%). Participants with a family history of AMD were 2.51 times as likely to have prevalent early AMD (95% CI, 1.44-4.37) compared to those without a family history, and males were 2.03 times as likely compared to females (95% CI, 1.57-2.63). Older age was associated with AMD and all lesions except RPE depigmentation, with participants aged 80 and over 4.41 times as likely to have early AMD compared to those in their 50s (95% CI, 2.88-6.77). Additionally, higher acculturation was protective for soft indistinct drusen (OR 0.57, 95% CI, 0.36-0.92), and having one or more barriers to care was a risk factor for RPE depigmentation (OR 1.81, 95% CI, 1.02-3.21).
AL, family history of AMD, acculturation, and barriers to care are associated with early AMD and/or AMD-related retinal lesions, independent of age and gender. Our finding that shorter AL is a risk factor for AMD among Chinese Americans is corroborated by a similar finding among Latinos and by results from several studies of Asian populations.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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