title: Prevalence, racial variations, and risk factors of age-related macular degeneration in Singaporean Chinese, Indians, and Malays.
abstract: OBJECTIVE
  To describe the prevalence and risk factors for age-related macular degeneration (AMD) in a multiethnic Asian cohort of Chinese, Malay, and Indian persons.
  
  
  METHODS
  Population-based cross-sectional study.
  
  
  METHODS
  A total of 10 033 persons (3280 Malay, 3400 Indian, and 3353 Chinese; response rate, 75%) 40 years of age or older residing in Singapore.
  
  
  METHODS
  We performed comprehensive systemic and ocular examinations, retinal photography, and laboratory investigations for all participants. We graded early and late AMD signs from retinal photographs using the modified Wisconsin AMD grading scale. We calculated the age-standardized prevalence of AMD using the 2010 Singapore adult population and analyzed risk factors for AMD using logistic regression models.
  
  
  METHODS
  Early and late AMD.
  
  
  RESULTS
  Of the 9799 participants with gradable photographs, 588 had early AMD and 60 had late AMD. The age-standardized prevalence was 5.1% (95% confidence interval [CI], 4.6-5.5) for early AMD and 0.5% (95% CI, 0.4-0.6) for late AMD. The prevalence of early AMD was similar between Chinese (5.7%) and Indian (4.5%; P = 0.27) persons and lower in Malays (3.5%; P = 0.002 compared with Chinese; P = 0.09 compared with Indians); in contrast, the prevalence for late AMD was similar across ethnic groups (Chinese, 0.6%; Indian, 0.3%; and Malay, 0.3%; P = 0.20). Risk factors for early AMD were older age (odds ratio [OR], 1.40 per 5-year increase in age; 95% CI, 1.33-1.47), male gender (OR, 1.81; 95% CI, 1.43-2.29), hypertension (OR, 1.28; 95% CI, 1.02-1.61), and hyperopic refraction (OR, 1.17 per 1-diopter increase in spherical equivalent; 95% CI, 1.11-1.24). Risk factors for late AMD include older age (OR, 1.87 per 5-year increase in age; 95% CI, 1.54-2.19), smoking more than 5 packs per week (OR, 3.63; 95% CI, 1.34-9.80), and presence of chronic kidney disease (OR, 2.17; 95% CI, 1.22-3.88).
  
  
  CONCLUSIONS
  Early AMD is more common in Chinese and Indians than in Malays, but there were no racial variations in the prevalence of late AMD.
authors.affiliation: Singapore National Eye Center, Singapore, Republic of Singapore; Singapore Eye Research Institute, Singapore, Republic of Singapore; Saw Swee Hock School of Public Health and Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore. Electronic address: gemmy.cheung.c.m@snec.com.sg.
authors.forename: Chui Ming Gemmy
authors.initials: CM
authors.lastname: Cheung
authors.affiliation: Singapore Eye Research Institute, Singapore, Republic of Singapore; Department of Statistics and Applied Probability, National University of Singapore, Singapore, Republic of Singapore.
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.affiliation: Singapore Eye Research Institute, Singapore, Republic of Singapore; Saw Swee Hock School of Public Health and Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Cheng
authors.affiliation: Singapore Eye Research Institute, Singapore, Republic of Singapore.
authors.forename: Yingfeng
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Center for Vision Research, University of Sydney, Sydney, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
authors.affiliation: Center for Vision Research, University of Sydney, Sydney, Australia; Center for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Melbourne, Australia.
authors.forename: Jie Jin
authors.initials: JJ
authors.lastname: Wang
authors.affiliation: Singapore National Eye Center, Singapore, Republic of Singapore; Singapore Eye Research Institute, Singapore, Republic of Singapore; Saw Swee Hock School of Public Health and Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore; Center for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Melbourne, Australia.
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000208:ethnology; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000208:ethnology*; D005260:Female; D006801:Humans; D007194:India / Q000208:ethnology; D008268:Macular Degeneration / Q000145:classification / Q000208:ethnology*; D008296:Malaysia / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D010781:Photography; D015995:Prevalence; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology