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Ronald Klein, MD, MPH; Limin Clegg, PhD; Lawton S. Cooper, MD, MPH; Larry D. Hubbard, MAT; Barbara E. K. Klein, MD, MPH; William N. King, MS; Aaron R. Folsom, MD; for the Atherosclerosis Risk in Communities Study Investigators

Arch Ophthalmol. 1999;117:1203-1210.

Objective  To describe the prevalence of age-related maculopathy (ARM) in blacks and whites and its relation to macrovascular disease and risk factors thereof in a population studied for cardiovascular disease risk factors and outcomes.

Population  A biracial population of 11,532 adults (ranging from 48-72 years of age; 8984 whites and 2548 blacks) living in 4 US communities (Forsyth County, North Carolina; the city of Jackson, Miss; selected suburbs of Minneapolis, Minn; and Washington County, Maryland) were examined during the interval from 1993 to 1995.

Methods  Drusen and other lesions typical of ARM were identified by examining a 45° color fundus photograph of 1 eye of each participant and classified by means of a modification of the Wisconsin Age-Related Maculopathy Grading System.

Results  The overall prevalence of any ARM was lower in blacks (3.7%) than whites (5.6%). After controlling for age and sex, the odds ratio for any ARM in blacks compared with whites was 0.73 (95% confidence interval, 0.58-0.91; P=.006). Few associations between atherosclerosis and its risk factors and the presence of early ARM or its component lesions were found. After adjusting for age, race, and sex, carotid artery plaque (odds ratio, 1.77; 95% confidence interval, 1.18-2.65) and focal retinal arteriolar narrowing (odds ratio, 1.79; 95% confidence interval, 1.07-2.98) were associated with retinal pigment epithelial depigmentation.

Conclusions  This population-based study documents the higher prevalence of early ARM in whites compared with blacks. Measures of atherosclerosis and its risk factors were generally unrelated to ARM and do not explain these racial differences.

From the Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison (Drs R. Klein and B. E. K. Klein and Messrs Hubbard and King); National Cancer Institute (Dr Clegg) and Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute (Dr Cooper), National Institutes of Health, Bethesda, Md; and Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis (Dr Folsom). A complete list of the Atherosclerosis Risk in Communities study investigators was published previously (Am J Epidemiol. 1989;129:687-701).

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