Prevalence and Risk Factors for Age-Related Macular Degeneration in the Elderly Chinese Population in Taiwan:The Puzih Eye Study

Abstract

Purpose: To describe the associated risk factors, age-specific prevalence, and sex-specific prevalence of drusen, early age-related macular degeneration (AMD), and late AMD in the elderly Chinese population in southwestern Taiwan

Methods: Grading digital color fundus photographs using the Wisconsin Age-Related Maculopathy Grading System

Results: A total of 708 participants were enrolled in the study; gradable fundus photos were acquired from 673 (95%; mean age, 72.47 years). The average age of the late AMD group was significantly more than that of the early AMD, drusen only, and no lesion groups, in that order (P = 0.014). The proportion of subjects with hypertension was significantly higher in the late AMD group than in the early AMD, drusen only, and no lesion groups, in that order (P = 0.028). The prevalence of drusen >500μm increased significantly with age in men (P = 0.019) and in the total cohort (P = 0.008). Early AMD was significantly more common in males than in females aged 80 years or more (P = 0.047). Soft drusen, early AMD, and late AMD were found in 40.6%, 13.1%, and 26.7% of the cohort, respectively. Hyperlipidemia for more than 10 years was a risk factor associated with early AMD. Old age, hypertension for more than 10 years, and exposure to sunlight were associated with late AMD.

Conclusions: The prevalence of early AMD (13.1%) in this elderly Chinese population in Taiwan was equivalent to that reported in white people in the European Eye Study (EUREYE) and in the Japanese in the Hisayama Study. However, the observed prevalence of late AMD (26.7%) is the highest ever reported anywhere in the world and conflicts with previous reports that AMD is less prevalent among Asians than among white people in Western countries.

Keywords: 412 age-related macular degeneration • 463 clinical (human) or epidemiologic studies: prevalence/incidence