Abstract
To examine the association of systemic, ocular and genetic risk factors in neovascular age-related macular degeneration (nAMD) in a large cohort of Asian patients, and to further compare risk factors between those with typical AMD and polypoidal choroidal vasculoapthy (PCV) subtypes. We recruited 456 cases and 1,824 controls matched for age, gender and ethnicity. Data on systemic and ocular risk factors were collected on questionnaires. In a subgroup of subjects, we included genetic data on four AMD-associated single nucleotide polymorphisms (SNPs). Risk factors for nAMD and subtypes were analyzed. Systemic risk factors for nAMD included older age, male gender, higher BMI and higher HDL-cholesterol. Ocular risk factors included pseudophakic and shorter axial length. Risk factors common to both typical AMD and PCV subtypes included age, BMI and HDL-cholesterol. Shorter axial length was only associated with PCV, while male gender and pseudophakia were only associated with typical AMD. In the subgroup with genotype data, ARMS2 rs10490924 and CFH rs800292 were associated with nAMD. None of the risk factors were significantly different between PCV and typical AMD. Systemic, ocular and genetic risk factors were largely similar for typical AMD and PCV subtypes in this Asian population based in Singapore.
Highlights
The risk factors for AMD in Asians have been less well studied, with three major limitations
With respect to late AMD, we previously reported that late AMD was associated with age, smoking >5 packs per week and chronic kidney disease in the population-based Singapore Epidemiology of Eye Disease study[14]
NAMD in Asians is often divided into typical AMD with clinical features similar to those seen in Western populations, and polypoidal choroidal vasculopathy (PCV)[1,28,29]
Summary
The risk factors for AMD in Asians have been less well studied, with three major limitations. NAMD in Asians is often divided into typical AMD with clinical features similar to those seen in Western populations, and polypoidal choroidal vasculopathy (PCV)[1,28,29] Whether these two subtypes are associated with different risk factors remains unclear. There is a pressing need to better understand the systemic, genetic and ocular risk factors for AMD in Asians To this end, we designed the Asian AMD Phenotyping Study in 2010 with the aim to study the clinical features and risk factors of Asian nAMD, including further subtyping into typical AMD and PCV according to angiographic features in every case. We performed case-control comparison of risk factors between 456 patients with nAMD and 1,824 controls free of AMD who were matched for age, gender and ethnicity
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