title: Ethnic variation in early age-related macular degeneration lesions between white Australians and Singaporean Asians.
abstract: OBJECTIVE
  We compared early age-related macular degeneration (AMD) lesion characteristics between white Australians and Singaporean Asians.
  
  
  METHODS
  Participants of the Blue Mountains Eye Study (BMES; whites, n = 3508) and the Singapore Epidemiology of Eye Disease Study (SEED; Malay, n = 3280, Indian, n = 3400, and Chinese, n = 3353) underwent examinations, including retinal photography. The AMD lesions were assessed following the Wisconsin AMD grading protocol by the same photographic grader. Prevalence and characteristics of early AMD lesions were compared between the BMES and the SEED. The associations between ethnicity and early AMD lesion types were analyzed using logistic regression models adjusting for age, sex, smoking status, lipids, and genetic polymorphisms associated with AMD.
  
  
  RESULTS
  After age-standardization to the BMES population, the prevalence of distinct soft drusen was significantly higher in Singaporeans compared to Australians (23.9%, 95% confidence interval [CI] 22.9-25.0 vs. 6.2%, 95% CI 5.3-7.0), with an adjusted odds ratio (OR) of 4.6 (95% CI 3.4-6.0). In contrast, the prevalence of indistinct soft or reticular drusen was significantly lower in Singaporeans compared to Australians (6.5%, 95% CI 5.9-7.1 vs. 8.3%, 95% CI 7.4-9.3, with nonsignificant adjusted OR of 1.2, 95% CI 0.8-1.7). Soft drusen of any type were present frequently at the inner and outer macula (within a zone ≥500 to <3000 μm radius from the foveal center) among Singaporeans, while among Australians soft drusen were present more frequently at the central macula (<500 μm radius).
  
  
  CONCLUSIONS
  Singaporean Asians had a milder spectrum of early AMD lesions and lesion characteristics (predominantly distinct soft drusen and noncentral location) compared to white Australians.
authors: Centre for Vision Research, Department of Ophthalmology, and Westmead Millennium Institute, University of Sydney, Sydney, Australia.
authors: Nichole
authors: N
authors: Joachim
authors: Centre for Vision Research, Department of Ophthalmology, and Westmead Millennium Institute, University of Sydney, Sydney, Australia.
authors: Paul
authors: P
authors: Mitchell
authors: Centre for Vision Research, Department of Ophthalmology, and Westmead Millennium Institute, University of Sydney, Sydney, Australia.
authors: Christine
authors: C
authors: Younan
authors: Centre for Vision Research, Department of Ophthalmology, and Westmead Millennium Institute, University of Sydney, Sydney, Australia.
authors: George
authors: G
authors: Burlutsky
authors: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
authors: Ching-Yu
authors: CY
authors: Cheng
authors: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
authors: Chui Ming Gemmy
authors: CM
authors: Cheung
authors: Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
authors: Yingfeng
authors: Y
authors: Zheng
authors: Centre for Vision Research, Department of Ophthalmology, and Westmead Millennium Institute, University of Sydney, Sydney, Australia.
authors: Mireille
authors: M
authors: Moffitt
authors: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
authors: Tien Yin
authors: TY
authors: Wong
authors: Centre for Vision Research, Department of Ophthalmology, and Westmead Millennium Institute, University of Sydney, Sydney, Australia.
authors: Jie Jin
authors: JJ
authors: Wang
mesh_terms: D000368:Aged; D044466:Asian People / Q000208:ethnology*; D001315:Australia / Q000453:epidemiology; D017242:Complement Factor H / Q000235:genetics; D005260:Female; D060005:Genotyping Techniques; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood; D008268:Macular Degeneration / Q000175:diagnosis / Q000208:ethnology* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D020641:Polymorphism, Single Nucleotide; D015995:Prevalence; D011506:Proteins / Q000235:genetics; D015593:Retinal Drusen / Q000175:diagnosis / Q000208:ethnology; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires; D044465:White People / Q000208:ethnology*
chemical_list: C514392:ARMS2 protein, human; C493495:CFH protein, human; D008075:Lipoproteins, HDL; D011506:Proteins; D017242:Complement Factor H
keywords: AMD; Asian; Australian; age-related macular degeneration; drusen; early AMD; late AMD; pigment