April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Ethnic Variation in the Distribution and Pattern of Early Age-related Macular Degeneration Lesions in Whites and Asians
Author Affiliations & Notes
  • Jie Jin Wang
    Ctr for Vision Research/Ophthalmol, Westmead Millennium Institute, University of Sydney C24, Westmead, NSW, Australia
  • Nichole Diane Lucy Joachim
    Ctr for Vision Research/Ophthalmol, Westmead Millennium Institute, University of Sydney C24, Westmead, NSW, Australia
  • Christine Younan
    Ctr for Vision Research/Ophthalmol, Westmead Millennium Institute, University of Sydney C24, Westmead, NSW, Australia
  • George Burlutsky
    Ctr for Vision Research/Ophthalmol, Westmead Millennium Institute, University of Sydney C24, Westmead, NSW, Australia
  • Ching-Yu Cheng
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
    Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
  • Gemmy Chui Ming Cheung
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
    Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
  • Yingfeng Zheng
    Saw Swee Hock School of Public Health,, National University of Singapore and National University Health System,, Singapore, Singapore
  • Mireille Moffitt
    Ctr for Vision Research/Ophthalmol, Westmead Millennium Institute, University of Sydney C24, Westmead, NSW, Australia
  • Tien Y Wong
    Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
    Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
  • Paul Mitchell
    Ctr for Vision Research/Ophthalmol, Westmead Millennium Institute, University of Sydney C24, Westmead, NSW, Australia
  • Footnotes
    Commercial Relationships Jie Jin Wang, None; Nichole Joachim, None; Christine Younan, None; George Burlutsky, None; Ching-Yu Cheng, None; Gemmy Cheung, Bayer Inc. (C), Novartis Inc. (C), Roche Inc. (C); Yingfeng Zheng, None; Mireille Moffitt, None; Tien Wong, Abott Inc. (C), Allergan Inc. (C), Bayer Inc. (C), Novartis Inc. (C), Roche Inc. (C); Paul Mitchell, Bayer Inc. (C), Novartis Inc. (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 6003. doi:
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      Jie Jin Wang, Nichole Diane Lucy Joachim, Christine Younan, George Burlutsky, Ching-Yu Cheng, Gemmy Chui Ming Cheung, Yingfeng Zheng, Mireille Moffitt, Tien Y Wong, Paul Mitchell; Ethnic Variation in the Distribution and Pattern of Early Age-related Macular Degeneration Lesions in Whites and Asians. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6003.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To compare pattern, distribution and characteristics of early age-related macular degeneration (AMD) lesions between white and Asian populations.

Methods: Population-based, cross-sectional studies of the Blue Mountains Eye Study (BMES; whites, n=3508) and the Singapore Epidemiology of Eye Disease Study (SEED, Malay, n=3280, Indian, n=3400 and Chinese, n=3353) were included. Retinal photographs were taken at examination and comprehensive questionnaires were administered. AMD lesions were assessed from retinal images, following the Wisconsin AMD grading protocol. The prevalence of AMD lesions, frequency of bilateral involvement, and early AMD lesion characteristics were compared between the BMES and the SEED after age standardization. The associations between ethnicity and early AMD lesion types were analyzed using logistic regression models adjusting for age, sex and smoking (current or past).

Results: Participants with early AMD were older and more likely to be women in the Australian compared to the Asian population. After age-standardization to the BMES population, the prevalence of distinct soft drusen was significantly higher in Asians compared to Australians (23.9%, 95% confidence interval (CI) 22.9-25.0 versus 6.2%, 95% CI 5.3-7.0), with an adjusted odds ratio (OR) 5.4 (95% CI 4.6-6.5). In contrast, the prevalence of indistinct soft or reticular drusen was lower in Asians compared to Australians (6.5%, 95% CI 5.9-7.1 versus 8.3%, 95% CI 7.4-9.3), though the adjusted OR 0.9 (95% CI 0.7-1.1) was not significant. Soft drusen of any type were frequently present at the inner macula (within a zone ≥500µm to <1500µm radius from the foveal centre) among Asians, while among Australians soft drusen were more frequently present at the central macula (<500µm radius) and more likely to involve a larger area than Asians. A smaller area of hyperpigmentation and location further from the fovea was more frequent in Asians compared to Australians.

Conclusions: A milder spectrum of early AMD lesions and lesion characteristics (predominantly distinct soft drusen and non-central location) was demonstrated in Asians compared to white Australians of similar age. These observations may reflect ethnic differences in risk factors and pathogenic pathways in AMD.

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