title: Prevalence and risks factors of age-related macular degeneration in Oklahoma Indians: the Vision Keepers Study.
abstract: OBJECTIVE
  To determine the prevalence of age-related macular degeneration (AMD) and to identify its risk factors in an Oklahoma Indian population.
  
  
  METHODS
  Cross-sectional study design.
  
  
  METHODS
  Included 1019 Oklahoma Indians who participated in baseline and second examinations of the Strong Heart Study.
  
  
  METHODS
  Retinal photographs of at least 1 eye were obtained and graded for AMD by the University of Wisconsin Ocular Epidemiology Reading Center. Retinal photographs of 986 participants were considered gradable and were included in the study.
  
  
  METHODS
  Age-related macular degeneration (early and late).
  
  
  RESULTS
  The overall prevalence of AMD in the study was 35.2%, including a prevalence of 0.81% for late AMD. The prevalence of early AMD increased from 30.6% in those aged 48 to 59 years to 46.1% in those 70 to 82 years of age. When potential risk factors were analyzed individually (univariate analyses), men with hypertension had a significantly higher prevalence of AMD (P = 0.02) than those without hypertension. In women, high-density lipoprotein cholesterol and sun exposure were associated positively with the prevalence of AMD (P = 0.01), whereas a history of using multivitamins was associated with lower AMD prevalence (P = 0.005). When multiple risk factors were analyzed simultaneously using logistic regression, only age showed significant association with AMD in both men (P = 0.02) and women (P<0.0001) and was the only significant risk factor in men. In women, multivitamin use and total cholesterol had a significant inverse association with AMD, whereas sun exposure and high-density lipoprotein cholesterol had a positive association. When men and women were combined, age and high-density lipoprotein cholesterol had significant positive associations, whereas total cholesterol, multivitamin use, and current alcohol use showed a significant inverse association with AMD.
  
  
  CONCLUSIONS
  This study was the first to report a detailed prevalence of AMD in Oklahoma Indians and its risk factors. The prevalence seemed to be relatively high compared with that in other ethnic groups. Some of the modifiable risk factors identified confirmed previous findings and can be used to design preventive programs to reduce the burden of AMD, although longitudinal data are still needed.
authors.affiliation: Center for American Indian Health Research, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Amir L
authors.initials: AL
authors.lastname: Butt
authors.forename: Elisa T
authors.initials: ET
authors.lastname: Lee
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.forename: Dana
authors.initials: D
authors.lastname: Russell
authors.forename: Gerald
authors.initials: G
authors.lastname: Ogola
authors.forename: Ann
authors.initials: A
authors.lastname: Warn
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Kingsley
authors.forename: Jeunliang
authors.initials: J
authors.lastname: Yeh
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D007198:Indians, North American / Q000706:statistics & numerical data*; D016015:Logistic Models; D008268:Macular Degeneration / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009825:Oklahoma / Q000453:epidemiology; D015995:Prevalence; D012160:Retina / Q000473:pathology; D012307:Risk Factors; D012737:Sex Factors; D013472:Sunlight / Q000009:adverse effects; D014815:Vitamins
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014815:Vitamins