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Original Investigation |

Prevalence of Age-Related Macular Degeneration in Chinese American Adults The Chinese American Eye Study

Rohit Varma, MD, MPH1; Farzana Choudhury, MBBS, PhD1; Sardius Chen, BA2; Shuang Wu, MS1; Chunyi Hsu, MPH1; Mina Torres, MS1; Ronald Klein, MD, MPH3; Stanley P. Azen, PhD4; Roberta McKean-Cowdin, PhD4 ; for the Chinese American Eye Study Group
[+] Author Affiliations
1University of Southern California Eye Institute, Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles
2Medical student, New York Medical College, School of Medicine, Valhalla
3Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison
4Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles
JAMA Ophthalmol. 2016;134(5):571-577. doi:10.1001/jamaophthalmol.2016.0588.
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Importance  Population-based prevalence estimates of age-related macular degeneration (AMD) need to be determined to assess its burden among Chinese Americans, the fastest growing racial group in the United States.

Objective  To determine the age- and sex- specific prevalence of AMD among Chinese Americans.

Design  The Chinese American Eye Study (CHES) was conducted in a general urban community of 10 census tracts in Monterey Park, California. A total of 4582 Chinese American adults aged 50 years or older participated in this population-based, cross-sectional study from February 16, 2010, through October 9, 2013, and underwent an interview as well as comprehensive clinical and eye examinations, including detailed retinal photography of both eyes. Fundus photographs were graded for drusen and retinal pigment epithelium abnormalities and were evaluated for AMD.

Main Outcomes and Measures  The prevalence of early and advanced AMD, drusen, geographic atrophy, and neovascular AMD were determined by using a modified Wisconsin Age-Related Maculopathy Grading Scale (a 6-level scale: 10, no AMD; 60, advanced AMD).

Results  Of the 4582 participants completing both the home survey and clinical examination, 4172 individuals (91.1%) had at least 1 gradable photograph. A total of 1526 (36.6%) participants were men, and the mean (SD) age was 61.2 (8.8) years. When examined by 10-year age groups, the prevalence of early AMD ranged from 5.8% (n = 119) in participants aged 50 to 59 years to 17.6% (n = 37) in those 80 years or older, retinal pigment epithelium abnormalities from 4.1% (n = 85) to 7.2% (n = 16), large drusen (≥125 µm) from 9.8% to 32.4%, soft drusen from 27.6% (n = 567) to 58.6% (n = 123), and soft indistinct drusen from 3.7% (n = 76) to 15.2% (n = 32). The prevalence of advanced AMD ranged from 0.2% (n = 3) in participants aged 50 to 59 years to 1.0% (n = 2) in those 80 years or older. Of the 14 cases of advanced AMD, 85.7% (95% CI, 57.2%-98.2%; n = 12) were neovascular AMD and 14.3% (95% CI, 2.0%-42.8%; n = 2) were geographic atrophy. Acute macular degeneration was more common in men (10.9% [9.3%-12.5%]; n = 166) than women (5.8% [4.9%-6.7%]; n = 154) in this cohort.

Conclusions and Relevance  Data from CHES suggest that Chinese Americans have a lower prevalence of early and advanced AMD compared with non-Hispanic white individuals. The prevalence of early AMD, advanced AMD, and large drusen was higher among Chinese Americans in CHES than among the Chinese population living in urban/rural China but lower than that in urban-dwelling Taiwanese.

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Participation Flowchart from the Chinese American Eye Study

Final cohort of analysis for assessing the prevalence of age-related macular degeneration.

aPhotographs were ungradable because of media opacities, poor camera focus, or maculopathies believed to be secondary to other conditions.

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