title: Smoking, alcohol intake, estrogen use, and age-related macular degeneration in Latinos: the Los Angeles Latino Eye Study.
abstract: OBJECTIVE
  To assess the association between smoking, alcohol intake, estrogen use, and both early age-related macular degeneration (AMD) (soft indistinct drusen, retinal pigment abnormalities) and advanced AMD (exudative AMD, geographic atrophy) in the Latino community.
  
  
  METHODS
  Population-based, cross-sectional study.
  
  
  METHODS
  Complete ophthalmic examination included stereoscopic macular photographs graded with a modified Wisconsin Age-related Maculopathy Grading System. A history of smoking, alcohol intake, and exogenous estrogen use was obtained by interview. Logistic regression was performed, and odds ratios (OR) were calculated with each AMD lesion as a dependent variable.
  
  
  RESULTS
  There were 5875 participants (92.4%) with gradable photographs. Having ever smoked was associated with a higher risk of having advanced AMD (OR, 2.4). Heavy consumption of alcohol (>5 drinks per session) was significantly associated with a greater risk of having exudative AMD (OR, 5.8) and geographic atrophy (OR, 12.7) Beer drinking was associated with a higher risk of having advanced AMD (OR, 2.9), whereas wine drinking appeared to be protective for increased retinal pigment (OR, 0.7). Exogenous estrogen use also appeared to be protective from soft indistinct drusen (OR, 0.5) and increased retinal pigment (OR, 0.6), but power was limited in the assessment of its association with advanced AMD.
  
  
  CONCLUSIONS
  Smoking and heavy alcohol consumption, particularly beer, was associated with a greater risk of having advanced AMD; exogenous estrogen use appeared to have a weak protective effect in Latino participants. Similar modifiable risk factors have been identified previously in non-Hispanic white patients, which suggests that common pathogenic mechanisms may be associated with AMD in persons of different ethnicities.
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Los Angeles, CA 90033, USA.
authors.forename: Samantha
authors.initials: S
authors.lastname: Fraser-Bell
authors.forename: Joanne
authors.initials: J
authors.lastname: Wu
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.forename: Stanley P
authors.initials: SP
authors.lastname: Azen
authors.forename: Rohit
authors.initials: R
authors.lastname: Varma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000208:ethnology*; D000434:Alcoholic Beverages / Q000706:statistics & numerical data; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008019:Life Style; D015141:Los Angeles / Q000453:epidemiology; D008268:Macular Degeneration / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D010781:Photography; D012307:Risk Factors; D012907:Smoking / Q000208:ethnology*; D011795:Surveys and Questionnaires
chemical_list: D003278:Contraceptives, Oral, Hormonal