Risk Factors for Four-Year Incidence and Progression of Age-Related Macular Degeneration: The Los Angeles Latino Eye Study
Risk Factors for Four-Year Incidence and Progression of Age-Related Macular Degeneration: The Los Angeles Latino Eye Study
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DOI：
10.1016/j.ajo.2011.02.025
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发表时间：
2011-09-01
影响因子：
4.2
通讯作者：
Azen, Stanley P.
中科院分区：
文献类型：
--
作者：
Choudhury, Farzana;Varma, Rohit;Azen, Stanley P.
目的：确定拉丁美洲成人年龄相关性黄斑变性（AMD） 4年发病率和进展的危险因素。设计：基于人群的前瞻性队列研究。方法：来自洛杉矶拉丁裔眼科研究（LALES）的40岁或以上的参与者在基线和4年随访时接受了标准化的综合眼科检查。使用改良的威斯康辛年龄相关性黄斑病变分级系统对30度立体眼底照片进行分级，检测老年性黄斑变性。采用多变量逐步logistic回归来检验AMD的发病率和进展与基线社会人口学、行为、临床和眼部特征之间的独立关联。结果：多因素分析显示，年龄较大（每10岁OR: 1.52; 95% CI: 1.29, 1.85）和脉压较高（每10毫米汞柱OR: 2.54; 95% CI: 1.36, 4.76）与任何AMD的发病率独立相关。同样的因素也与早期AMD、软性模糊色斑和视网膜色素异常有关。此外，临床诊断为糖尿病的存在与视网膜色素增加独立相关（OR: 1.66; 95% CI: 1.01, 2.85），男性与视网膜色素上皮色素沉着相关（OR: 2.50; 95% CI: 1.48, 4.23）。年龄较大（OR / 10岁：2.20;95% CI: 1.82, 2.67）和当前吸烟（OR: 2.85; 95% CI: 1.66, 4.90）与AMD的进展独立相关。结论：几个可改变的危险因素与拉丁美洲人AMD的4年发病率和进展有关。结果表明，旨在降低脉压和促进戒烟的干预措施可能分别减少AMD的发病率和进展。[J]中华眼科杂志，2011;32(2):385-395。(C)爱思唯尔公司2011。版权所有。)
PURPOSE: To identify risk factors for 4-year incidence and progression of age-related macular degeneration (AMD) in adult Latinos.DESIGN: Population-based prospective cohort study.METHODS: Participants, aged 40 or older, from The Los Angeles Latino Eye Study (LALES) underwent standardized comprehensive ophthalmologic examinations at baseline and at 4 years of follow-up. Age-related macular degeneration was detected by grading 30-degree stereoscopic fundus photographs using the modified Wisconsin Age-Related Maculopathy Grading System. Multivariate stepwise logistic regression was used to examine the independent association of incidence and progression of AMD and baseline sociodemographic, behavioral, clinical, and ocular characteristics.RESULTS: Multivariate analyses revealed that older age (OR per decade of age: 1.52; 95% CI: 1.29, 1.85) and higher pulse pressure (OR per 10 mm Hg: 2.54; 95% CI: 1.36, 4.76) were independently associated with the incidence of any AMD. The same factors were associated with early AMD, soft indistinct drusen, and retinal pigmentary abnormalities. Additionally, presence of clinically diagnosed diabetes mellitus was independently associated with increased retinal pigment (OR: 1.66; 95% CI: 1.01, 2.85), and male gender was associated with retinal pigment epithelial depigmentation (OR 2.50; 95% CI: 1.48, 4.23). Older age (OR per decade of age: 2.20; 95% CI: 1.82, 2.67) and current smoking (OR: 2.85; 95% CI: 1.66, 4.90) were independently associated with progression of AMD.CONCLUSIONS: Several modifiable risk factors were associated with 4-year incidence and progression of AMD in Latinos. The results suggest that interventions aimed at reducing pulse pressure and promoting smoking cessation may reduce incidence and progression of AMD, respectively. (Am J Ophthalmol 2011;152:385-395. (C) 2011 by Elsevier Inc. All rights reserved.)