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Caleb Ng, Samuel Kim, Michael M Lai; Wet Age-Related Macular Degeneration in Asian Americans and non-Asians: An Analysis of Comparative Outcomes. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5547.
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To compare the presentation, clinical course, and outcomes of wet age-related macular degeneration (wAMD) between Asian-Americans (AA) and non-Asian Americans (NAA) in a single retina practice.
A retrospective comparative case series of consecutive patients seen by a single retina specialist at a tertiary retina practice between 1/1/2010 and 12/31/2014 with newly diagnosed wAMD. Patients were included into AA group if they identified as ethnically Asian. Exclusion criteria included previous treatments for wAMD, choroidal neovascularization secondary to non-AMD causes, and follow-up less than 12 months. Studied variables included baseline demographics, vision and anatomic features at presentation, treatments performed, and visual and anatomic outcomes at 3, 6, and 12 months.
40 eyes from 32 AA patients and 218 eyes from 171 NAA patients met the inclusion and exclusion criteria.Mean age at presentation was 74.75 (AA) vs 79.52 (NAA) (p = 0.0612, unpaired t-test). 21 patients were male and 11 female in AA vs 56 males and 105 females in NAA (P = 0.0015). 6/32 AA vs 40/171 (p=1) NAA patients were smokers.Mean visual acuity for AA eyes was 20/118 at the time of diagnosis, 20/91 at 3 months, 20/93 at 6 months, and 20/93 at 12 months. Mean visual acuity for NAA eyes was 20/89 at the time of diagnosis, 20/78 at 3 months, 20/74 at 6 months, and 20/58 at 12 months. T-test analysis of the differences between the two groups from baseline to 12 month follow-up was statistically significant (P<0.05).AA group required average of 5.3 injections during 12 month follow up, whereas NAA group required 5.8 during the same span (p=1).70.8% of AA group had pigment epithelial detachment on presentation (PED) vs 38% in the NAA group (p<0.005, Fisher’s test). 37.5 percent (15/40) of AA had polypoidal features, vs 12 percent (26/218) of NAA had these features (p<0.005, Fisher’s test). No clinically significant differences were found regarding subretinal fluid, intraretinal edema, and hemorrhage between the two groups.
Compared to non-Asian patients, Asian-American patients were more likely to be diagnosed with wet AMD at an earlier age, show male predominance, have PED and polypoidal features with worse visual acuity at presentation, and were less likely to experience visual improvement in the first 12 months with standard anti-VEGF treatment.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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