Purpose:
To evaluate the associations between early/late age-related macular degeneration (AMD) and systemic and ocular parameters using national population-based data.
Methods:
From 2008 to 2012, a total of 16,897 participants of the Korea National Health and Nutrition Examination Survey underwent ophthalmologic examinations by the Korean Ophthalmological Society. Cases of early and late (neovascular and geographic atrophy) AMD were identified using digital fundus images. Risk factors were identified using logistic regression.
Results:
Age-standardized prevalence of early and late AMD among subjects aged 40 years and older was 5.5% and 0.6%, respectively. Increasing age was the most significant risk factor for both early and late AMD (adjusted odds ratio [aOR]: 1.09, 95% confidence interval [CI]; 1.07?1.10; aOR: 1.14, 95% CI: 1.10?1.19, respectively). Patients who slept, on average, more than nine hours per day (aOR: 0.68, 95% CI: 0.47?1.00) and who were in the lowest quintile (≤ 38.21 g/dL) of high-density lipoprotein (HDL) cholesterol (aOR: 0.68, 95% CI: 0.51?0.92) were significantly associated with a lower prevalence of early AMD. Increasing spherical equivalent (SE) [aOR]: 0.53 of the first quintile of SE ≤ -1.38 diopters (D), 95% CI: 0.35?0.78; aOR: 1.41 of the fifth quintile of SE ≥ +0.69 D, 95% CI: 1.07?1.86] was associated with a higher prevalence of early AMD. Lower quartile of systolic blood pressure (≤ 110.0 mmHg) was associated with a lower prevalence of neovascular AMD (aOR): 0.25, 95% CI: 0.09?0.67).
Conclusions:
Aging was the most significant risk factor for both early and late AMD. Lower level of HDL cholesterol, longer duration of sleep, and myopia had protective associations with early AMD, while lower systolic blood pressure had a protective association with neovascular AMD.