Age-Related Macular Degeneration in Ethnically Diverse Australia: Melbourne Collaborative Cohort Study

Abstract

Purpose: To determine and compare the prevalence of age-related macular degeneration (AMD) in older Australians of Anglo-Celtic and Southern European origin.

Methods: A total of 21,132 participants of the Melbourne Collaborative Cohort Study, aged 47–86 years, were assessed for AMD in 2003–2007 with non-mydriatic fundus photography. Of these, 14% were born in Southern Europe (Greece, Italy or Malta), with the remaining 86% of Anglo-Celtic origin, born in Australia, the United Kingdom or New Zealand.

Results: Overall, 2694 participants (12.7%) had early stages of AMD, defined as either one or more drusen ≥125 μm (with or without pigmentary abnormalities) or one or more drusen 63–124 μm with pigmentary abnormalities in a 6000-μm diameter grading grid, in the absence of late AMD in either eye. A total of 122 participants (0.6%) had late AMD, defined as either geographic atrophy or neovascular AMD. In logistic regression analysis, adjusted for age, sex, smoking, education and physical activity, Southern Europeans compared to Anglo-Celts had a higher prevalence of the early stages of AMD (odds ratio, OR, 1.15, 95% confidence interval, CI, 1.00–1.34), and lower prevalence of late AMD (OR 0.36, 95% CI 0.17–0.78).

Conclusions: Australians of Southern European origin have a higher prevalence of the early stages of AMD and lower prevalence of late AMD compared to those of Anglo-Celtic origin. Although AMD prevalence in the older age group(s) of Southern Europeans could be underestimated due to disparity in participation rates, it is likely that both lifestyle and genetic factors play their parts in differential AMD prevalence in these ethnic groups.

• Age-related macular degeneration (AMD)
• ethnicity
• prevalence

Acknowledgments

GGG, DRE and JLH designed, raised funds and conducted the parent MCCS; LDR, RHG, and PNB designed and raised funds for AMD research in the MCCS. EWC, KZA, GAM, LDR, MKMA and RHG collected and validated the ophthalmic data. LDR and FMAI conducted the statistical analysis, MKMA, RHG and JAS contributed to data analysis. LDR and RHG supervised the ophthalmic part of the MCCS and wrote the paper.

All authors critically revised the manuscript, contributed to writing and approved the final version for submission.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Cohort recruitment was funded by VicHealth and The Cancer Council Victoria. Further MCCS funding: the National Health & Medical Research Council of Australia (NHMRC) Program Grant 209057, Capacity Building Grant 251533 and Enabling Grant 396414. The ophthalmic component was funded by the Ophthalmic Research Institute of Australia; American Health Assistance Foundation, Jack Brockhoff Foundation, John Reid Charitable Trust, Perpetual Trustees and Royal Victorian Eye and Ear Hospital. People support was provided through the NHMRC Career Development (300052) and Practitioner (529905) Fellowships to RHG, Wagstaff Fellowship to LR, NHMRC PhD scholarship (590226) and Hugh Noel Puckle Scholarship to MA, NHMRC Senior Research Fellowships to PNB (1028444) and JH (1023434), and Novartis Medical Retinal Fellowship to EC. Centre for Eye Research Australia is a recipient of the NHMRC Centre for Clinical Research Excellence Grant 529923 and Operational Infrastructure Support from the Victorian Government. The funding organizations did not have any involvement in study design and data collection, analysis or interpretation.