Author(s): Burkemper B, McKean-Cowdin R, Choudhury F, Klein R, Gauderman WJ, Jiang X, Hsu C, Torres M, Varma R; Chinese American Eye Study Group. Factors associated with age-related macular degeneration in Chinese American adults: The Chinese American Eye Study (CHES). Ophthalmol Retina. 2018 Mar;2(3):209-216. doi: 10.1016/j.oret.2017.07.001. Epub 2017 Oct 12. PMID 31047588
Journal: Ophthalmology. Retina, Volume 2, Issue 3, Mar 2018
OBJECTIVE To assess associations between age-related macular degeneration (AMD) and multiple factors comprising a conceptual model of AMD risk in a population of Chinese Americans, and to draw comparisons with a similar risk assessment of a Latino population.
DESIGN A cross-sectional population-based study.
PARTICIPANTS We enrolled 4582 Chinese Americans aged ≥50 residing in Monterey Park, California.
METHODS Participants completed a comprehensive eye examination, including stereoscopic fundus photography and ocular biometric measurements. Fundus images were graded using a modified version of the Wisconsin Age-Related Maculopathy Grading System.
MAIN OUTCOMES AND MEASURES Odds ratios for factors significantly modifying the risk of AMD and its related retinal lesions.
RESULTS Of the eligible participants, 4172 (72%) had fundus photographs gradable for AMD. Early AMD was present in 375 eyes (4.6%), and late AMD was present in 17 (0.2%). Shorter axial length, male sex, older age, and family history of AMD were identified as independent risk factors for prevalent AMD and its characteristic retinal lesions using a conceptual model of potential AMD risk factors. Of 4 AMD risk factors identified for Latinos, 3 (older age, male sex, shorter axial length) overlapped with those identified for Chinese Americans, with an association similar in magnitude and direction. Lower levels of education were a risk factor specific to Latinos. Based on a multivariable logistic regression model, the predicted probability of early AMD was 31% lower among Chinese Americans relative to Latinos (95% confidence interval [CI], 17%-43%). Chinese Americans also had statistically significantly lower odds of any AMD and 2 types of early retinal lesions symptomatic of AMD.
CONCLUSIONS Factors associated with prevalent AMD are similar for Chinese Americans and Latinos. Chinese Americans who were older, were male, had a family history of AMD, and had a shorter axial length were at an increased risk for AMD compared with those without these risk factors. We observed a significantly lower predicted prevalence of AMD among Chinese Americans compared with Latinos, even after controlling for all relevant covariates, suggesting that additional genetic or lifestyle differences may play an important role in determining AMD risk.