Centre for Vision Research, Department of Ophthalmology, and Westmead Millennium Institute, University of Sydney, Sydney, Australia.
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
Invest Ophthalmol Vis Sci. 2014 Jun 26;55(7):4421-9. doi: 10.1167/iovs.14-14476.
We compared early age-related macular degeneration (AMD) lesion characteristics between white Australians and Singaporean Asians.
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.
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).
Singaporean Asians had a milder spectrum of early AMD lesions and lesion characteristics (predominantly distinct soft drusen and noncentral location) compared to white Australians.
我们比较了白种澳大利亚人和新加坡亚裔人群中与年龄相关的早期黄斑变性（AMD）病变特征。
参与蓝山眼研究（BMES；白人，n=3508）和新加坡眼病流行病学研究（SEED；马来人，n=3280，印度人，n=3400，中国人，n=3353）的参与者接受了视网膜摄影检查。AMD 病变按照威斯康星 AMD 分级方案，由同一位摄影分级员进行评估。比较了 BMES 和 SEED 中早期 AMD 病变的患病率和特征。使用逻辑回归模型，在调整年龄、性别、吸烟状况、血脂和与 AMD 相关的遗传多态性后，分析了种族与早期 AMD 病变类型之间的关联。
在按 BMES 人群年龄标准化后，新加坡人明显具有更高的明确软性玻璃疣患病率（23.9%，95%置信区间[CI]22.9-25.0 与 6.2%，95%CI5.3-7.0），调整后的优势比（OR）为 4.6（95%CI3.4-6.0）。相比之下，新加坡人的不明确软性或网状玻璃疣患病率明显低于澳大利亚人（6.5%，95%CI5.9-7.1 与 8.3%，95%CI7.4-9.3，调整后的 OR 为 1.2，95%CI0.8-1.7）。在新加坡人群中，任何类型的软性玻璃疣都常在内、外黄斑区（从黄斑中心凹内 500 至<3000μm 半径范围内的区域）存在，而在澳大利亚人群中，软性玻璃疣则更常存在于中央黄斑区（<500μm 半径）。
与白种澳大利亚人相比，新加坡亚裔人群具有更轻微的早期 AMD 病变谱和病变特征（主要为明确的软性玻璃疣和非中央位置）。
