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B. L. VanderBeek, D. N. Zacks, N. Talwar, B. Nan, D. C. Musch, J. D. Stein; Racial and Ethnic Differences in the Risk for Non-Exudative and Exudative Age-Related Macular Degeneration Among Asian Americans Compared With Other Races. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1626.
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To determine the risk of developing non-exudative and exudative age-related macular degeneration (AMD) among Asian Americans as compared to other races and whether differences in AMD risk vary by Asian ethnicity.
Claims data from a large, national U.S. managed care network was reviewed to identify individuals age ≥40 who had one or more visits to an eye care provider from 2001-2007. ICD-9 billing codes were used to identify enrollees with non-exudative and exudative AMD. Prevalence rates were calculated for non-exudative and exudative AMD. Univariate and multivariate Cox regression analyses were performed to determine the hazard of developing non-exudative and exudative AMD for individuals of different races and among persons of different Asian ethnicities, with adjustment for sociodemographic factors, ocular and medical conditions.
Of the 2,259,061 enrollees who met the inclusion criteria, 113,234 (5.01%) had non-exudative AMD and 17,181 (0.76%) had exudative AMD. The unadjusted prevalence of non-exudative AMD and exudative AMD was lower for Asian Americans (5.04% and 0.49%, respectively) as compared to non-Hispanic whites (5.40% and 0.84%). After adjusting for age and other potential confounding factors, Asian Americans had a 20% increased hazard for non-exudative AMD (adjusted HR=1.20, CI 1.13-1.27) compared with non-Hispanic whites. There was no significant difference in the hazard of developing exudative AMD among Asian Americans compared with non-Hispanic whites, (HR=0.86, CI 0.71-1.03). Chinese Americans (adjusted HR = 1.63, CI 1.50-1.77) and Pakistani Americans (adjusted HR = 1.97, CI 1.40-2.77) had a significantly increased hazard of developing non-exudative AMD compared with non-Hispanic whites. By contrast, Japanese Americans had a 29% decreased hazard of non-exudative AMD compared with whites (adjusted HR = 0.71, CI 0.59-0.85). There was no significant difference in hazard for developing exudative AMD among each of the Asian ethnicities and that of non-Hispanic whites.
Asian Americans are the second fastest growing race within the US. Eye care providers need to be aware of the overall disease burden of AMD within this group as well as how disease rates can differ substantially between different Asian ethnicities.
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