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Cited by 304Retinal Diseases and TreatmentsRetinal Imaging and AnalysisGlaucoma and retinal disorders

Racial differences in the prevalence of age-related macular degeneration

Open access
Friedman, David S, Katz, Joanne, Bressler, Neil M, Rahmani, Bahram, Tielsch, James M·1999·Ophthalmology
DOI 10.1016/s0161-6420(99)90267-1
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Abstract

OBJECTIVE: To determine differences in the prevalence of age-related macular degeneration (AMD) and its fundus manifestations in a population-based sample of older black and white Americans. DESIGN: Cross-sectional population-based study of 2520 participants of whom 1854 are white and 666 are black. Mean age was 73.5 years. Stereoscopic color fundus photographs were graded for presence, severity, and location of drusen, retinal pigment epithelium abnormalities, and choroidal neovascularization or disciform scarring. RESULTS: Drusen at least 64 microm in size were identified in 56% of black and white individuals within 3000 microm of the foveal center, but drusen larger than 125 microm were more common among white participants (16% white vs 11% black individuals). Drusen at least 250 microm in size, confluent drusen, or a larger area (> 10%) occupied by drusen were each more common among white participants. White individuals were 3 times more likely to have focal hyperpigmentation than black individuals. Racial differences were most pronounced for features within the central 1500-microm macular zone. Neovascular AMD was present in 1.7% of white participants and 1.1% of black participants (age-adjusted, P = .38), whereas geographic atrophy was more common in white than black individuals (1.8% vs 0.3%; age-adjusted, P = .02). CONCLUSIONS: White persons are generally more likely than black persons to have medium or large drusen, focal pigment abnormalities, and advanced AMD. Racial differences were prominent for nonneovascular AMD features only when present in the central zone. These data suggest that black individuals may have a mechanism for protection in the central zone against these critical fundus features, which themselves convey high risk of progression to advanced AMD.

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  • Age is the strongest risk factor for age-related macular degeneration; all population-based studies confirm that the prevalence of age-related macular degeneration increases with age in white individuals.

    “Age is the strongest risk factor for age-related macular degeneration; all population-based studies confirm that the prevalence of age-related macular degeneration increases with age in white individuals.3,22–27”

    From Age-related macular degeneration (2008) · cites this paper as [25]

  • Drusen are seen at similar frequencies in white and non-white individuals.

    “Data from the Barbados Eye Study,42 the Baltimore Eye Study,25 the Age-Related Eye Disease Study (AREDS),28 and the National Health and Nutrition Examination Survey III (NHANES III)41 have shown that drusen are seen at similar frequencies in white and non-white individuals.”

    From Age-related macular degeneration (2008) · cites this paper as [25]

  • There is a definite increased prevalence of advanced age-related macular degeneration in white people compared with others.

    “However, these studies also show a definite increased prevalence of advanced age-related macular degeneration in white people compared with others.”

    From Age-related macular degeneration (2008) · cites this paper as [25]

  • In persons of African origin living in the United States and Barbados, the prevalence of early AMD and soft drusen is slightly lower than in whites, but advanced AMD is rare.

    “Interestingly, in persons of African origin living in United States and Barbados, prevalence of early AMD and soft drusen is slightly lower than in whites, but advanced AMD is rare [34,35].”

    From CFH Y402H confers similar risk of soft drusen and both forms of advanced AMD (2005) · cites this paper as [34]

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1 of the 41 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Leske MC, Connell AMS, Schachat AP, Hyman L. The Bar- bados Eye Study. Prevalence of open angle glaucoma. Arch Ophthalmol 1994;112:821-9.

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Authors
Friedman, D. S., Katz, J., Bressler, N. M., Rahmani, B., & Tielsch, J. M.
Affiliations
Johns Hopkins University (US)
Corresponding author
Friedman, David S
ORCID
Venue
Ophthalmology
Publisher
Elsevier BV
Published
1999-06
Volume
106
Issue
6
Pages
1049-1055
ISSN
  • 0003-9950 (ISSN-L)
  • 0161-6420
DOI
10.1016/s0161-6420(99)90267-1
OpenAlex
W2006572461
Cited by
304
References
41
Citations by year
2026: 3 · 2025: 7 · 2024: 7 · 2023: 9 · 2022: 6 · 2021: 9 · 2020: 15 · 2019: 9 · 2018: 4 · 2017: 11 · 2016: 10 · 2015: 19 · 2014: 17 · 2013: 22 · 2012: 12
FWCI
7.28
Type
journal article
Language
en
Open access
Licence
Locations
  • Archives of Ophthalmology (publishedVersion)
  • Ophthalmology (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01ey003605-10, 5r01ey005091-05, 5k08ey000358-02)
  • National Institute on Aging (AG16294, R01AG016294)
Topics
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
  • Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
Keywords
age-related macular degeneration, racial differences, Black and White Americans, drusen, retinal pigment epithelium abnormalities, choroidal neovascularization, geographic atrophy, fundus photography, prevalence, older adults
MeSH terms
Adult, Aged, Aged, 80 and over, Black or African American, Cross-Sectional Studies, Female, Fundus Oculi, Health Surveys, Humans, Macular Degeneration, Male, Middle Aged, Photography, Risk Factors, Baltimore, Prevalence, Odds Ratio, Black People, White People

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