Racial Differences and Other Risk Factors for Incidence and Progression of
Age-Related Macular Degeneration: Salisbury Eye Evaluation (SEE) Project
Margaret Amy Chang 1*,
Susan B. Bressler 1,
Beatriz Munoz 2,
and
Sheila K. West 2
1 Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland, United States
2 Wilmer Eye Institute, Dana Center, Johns Hopkins University, Baltimore, Maryland, United States
* To whom correspondence should be addressed. E-mail: mchang19{at}jhmi.edu.
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Abstract |
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Purpose: To evaluate risk factors for the incidence and progression of age-related macular degeneration (AMD) in a racially heterogeneous, geriatric population.
Methods: 2240 subjects aged 65 to 84 years underwent 2 examinations separated by 2 years, of which 1937 subjects (85%) were included in this report. Fundus photographs were performed at each exam and were graded by trained readers. Multivariable logistic regression models adjusted for age, gender, race, and clustering between eyes were used to evaluate risk factors for AMD incidence and progression.
Results: Smoking was a strong, dose dependent, risk factor for progression from medium size drusen to large drusen or pigmentary abnormalities within the central 1500 micron macular zone. Smoking was also a strong risk factor for development of incident focal pigmentation within 3000 microns of the foveal center. White participants were significantly more likely than blacks to develop large drusen, focal pigmentation, and progress from medium-size drusen to large drusen or pigment abnormalities within the central 1500 micron macular zone. However, whites did not have an increased risk of progression from large drusen or pigment abnormalities within the central 1500 micron perimacular zone to foveal GA or CNV when compared to blacks.
Conclusions: Smoking and race are important risk factors for progression from medium to large drusen or to pigment abnormalities within the central 1500 micron macular zone. Limitations in the power of this study preclude assessment of the roles of smoking and race on the ultimate progression to foveal GA or CNV once central large drusen or pigment abnormalities are present.
Key Words:
age-related macular degeneration, epidemiology, macular degeneration
