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Retina. 2014 Aug;34(8):1539-53. doi: 10.1097/IAE.0000000000000118.

Associations between cardiovascular risk factors and early age-related macular degeneration in a rural Chinese adult population.

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*Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China; †Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, China; ‡Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; §Singapore Eye Research Institute, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; and ¶Centre for Vision Research, Department of Ophthalmology, and Westmead Millennium Institute, University of Sydney, Sydney, Australia. Centre of Eye Research Australia, Melbourne University, Melbourne, Australia.



There have been a limited number of population-based studies investigating the associations between cardiovascular disease risk factors and early age-related macular degeneration (AMD).


A total of 7,557 eligible people aged 30 or older were recruited from 2006 to 2007. Cardiovascular risk factors and serum lipids including total cholesterol, total triglycerides, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and fasting plasma glucose, and urines were assessed. Digital photographs of the optic disk and macula fields (Early Treatment of Diabetic Retinopathy Study) were taken and graded after the modified Wisconsin Age-related Maculopathy Grading System. Logistic regression models were constructed to assess odds ratios and 95% confidence intervals. Cases of late AMD were excluded.


Of 6,577 subjects included in the analysis, there were 200 (3.04%) cases with early AMD. Multivariate analysis showed that higher age, untreated hypertension, coronary heart disease, and smoking were associated with an increased risk of early AMD. After adjusting for other variables in the final model, no variable was significantly associated with hyperpigmentation while smoking was significantly associated with an increased risk of hypopigmentation; higher age and any cardiovascular disease were associated with an increased risk of large drusen, and higher age, smoking, untreated hypertension, and coronary heart disease were associated with an increased risk of soft drusen.


Our findings support the associations between smoking, coronary heart disease, and early AMD.

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