Elsevier

Ophthalmology

Volume 113, Issue 3, March 2006, Pages 373-380
Ophthalmology

Original Article
Prevalence of Age-Related Macular Degeneration in 4 Racial/Ethnic Groups in the Multi-ethnic Study of Atherosclerosis

https://doi.org/10.1016/j.ophtha.2005.12.013Get rights and content

Objective

To describe the prevalence of age-related macular degeneration (AMD) in 4 racial/ethnic groups (white, black, Hispanic, and Chinese) that participated in the second examination of the Multi-ethnic Study of Atherosclerosis (MESA).

Participants

Six thousand one hundred seventy-six 45- to 85-year-old subjects selected from 6 United States communities.

Methods

Fundus images were taken using a 45° digital camera through dark-adapted pupils and were graded for drusen size, type, area, increased retinal pigment, retinal pigment epithelial depigmentation, neovascular lesions, and geographic atrophy using the modified Wisconsin Age-Related Maculopathy Grading System.

Main Outcome Measure

Age-related macular degeneration.

Results

Prevalences of AMD were 2.4% (black), 4.2% (Hispanic), 4.6% (Chinese), to 5.4% (white) (P<0.001 for any differences among groups). The highest prevalence of any AMD occurred in those 75 to 84 years old, varying from 7.4% in blacks to 15.8% in whites and Chinese (P = 0.03). Estimated prevalences of late AMD were 0.3% (black), 0.2% (Hispanic), 0.6% (white), and 1.0% (Chinese). These differences were marginally significant (age and gender adjusted, P = 0.08). The frequency of exudative AMD was highest in Chinese (age- and gender-adjusted odds ratio, 4.30; 95% confidence interval, 1.30–14.27) compared with whites. Differences in age, gender, pupil size, body mass index, smoking, alcohol drinking history, diabetes, and hypertension status did not explain the variability among the 4 racial/ethnic groups.

Conclusions

Low prevalences of AMD were found in the MESA cohort in all groups. A lower prevalence of AMD was found in blacks compared with whites. The higher prevalence of exudative AMD in Chinese needs further study.

Section snippets

Subjects and Study Design

The MESA is a 10-year longitudinal study supported by the National Heart, Lung, and Blood Institute with the goals of identifying risk factors for subclinical atherosclerosis, for quantitative progression of subclinical atherosclerosis, and for transition from subclinical disease to clinically apparent events.15 The MESA cohort includes 6814 men and women 45 to 84 years old at baseline (July 2000 to July 2002) who were recruited from 6 field centers: Baltimore, Maryland; Chicago, Illinois;

Participants

Of the 6814 participants seen at baseline, 6176 participated in the second study visit when retinal images were acquired. Persons who participated were more likely at baseline to be younger (62.4 vs. 65.1 years, P<0.001), to be male (47.7% vs. 41.9%, P = 0.005), not to be black (27.2% vs. 34.6%) or Hispanic (21.6% vs. 25.1%, P<0.001), and not to have a history of hypertension (43.6% vs. 51.1%, P<0.001) or diabetes (14.4% vs. 22.6%, P<0.001) than nonparticipants at the second study visit.

Of the

Discussion

The MESA provided a unique opportunity to examine the frequency of any AMD in 4 racial/ethnic groups living in 6 U.S. communities. Age-related macular degeneration was measured by grading of fundus digital images in a masked fashion by means of a standard classification system.

The overall prevalence of any AMD varied from 2.4% in blacks, 4.2% in Hispanics, 4.6% in Chinese, to 5.4% in whites. The lower frequency in blacks versus whites was similar to data from earlier studies.7, 11 Unexpectedly,

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    Manuscript no. 2005-445.

    This study was supported by National Institutes of Health, Bethesda, Maryland (grant no.: HL69979-03 [RK, TYW]), and Research to Prevent Blindness, New York, New York (Senior Scientific Investigator Award [RK, BEKK]).

    The authors do not have any conflicts of interest related to the article.

    A full list of participating Multi-ethnic Study of Atherosclerosis investigators and institutions can be found at http://www.mesa-nhlbi.org (under “MESA P&P Policy/Acknowledgements”).

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