title: Rates of nonexudative and exudative age-related macular degeneration among Asian American ethnic groups.
abstract: OBJECTIVE
  To determine whether the risk for nonexudative and exudative age-related macular degeneration (AMD) varies for Americans of different Asian ethnicities.
  
  
  METHODS
  Claims data from a large national United States managed care network were reviewed to identify Asian Americans age 40 and older who had ≥ 1 eye care visits from 2001 to 2007. International Classification of Disease (ICD-9CM) billing codes were used to identify enrollees with nonexudative and exudative AMD. Incidence and prevalence rates were calculated for nonexudative and exudative AMD and were stratified by Asian ethnicity. Cox regression analyses were performed to determine the relative risk for developing nonexudative and exudative AMD for persons of different Asian ethnicities, with adjustment for sociodemographic factors and ocular and medical conditions.
  
  
  RESULTS
  Of the 44,103 Asian Americans who met the inclusion criteria, 2221 (5.04%) had nonexudative AMD and 217 (0.49%) had exudative AMD. Chinese Americans (adjusted hazard ratio [HR], 1.63; 95% confidence interval [CI], 1.50-1.77) and Pakistani Americans (HR, 1.97, 95% CI, 1.40-2.77) had a significantly increased risk for nonexudative AMD compared with non-Hispanic white Americans. By contrast, Japanese Americans had a 29% decreased risk for nonexudative AMD compared with non-Hispanic white Americans (HR, 0.71; 95% CI, 0.59-0.85). There were no significant differences in risk for exudative AMD for any of the Asian ethnicities compared with white Americans.
  
  
  CONCLUSIONS
  Asian Americans are the second fastest growing racial group in the United States. Eye care providers must be aware of the overall disease burden of AMD within this group and appreciate how disease rates can vary substantially among different Asian ethnicities.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA. jdstein@med.umich.edu
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Stein
authors.forename: Brian L
authors.initials: BL
authors.lastname: Vanderbeek
authors.forename: Nidhi
authors.initials: N
authors.lastname: Talwar
authors.forename: Bin
authors.initials: B
authors.lastname: Nan
authors.forename: David C
authors.initials: DC
authors.lastname: Musch
authors.forename: David N
authors.initials: DN
authors.lastname: Zacks
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D005260:Female; D006801:Humans; D015994:Incidence; D008268:Macular Degeneration / Q000208:ethnology*; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D057135:Wet Macular Degeneration / Q000208:ethnology