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The Blue Mountains Eye Study

Amy Shih-I Pai, MBBS, BSc(Med); Paul Mitchell, MD, PhD; Elena Rochtchina, MAppStat; Sudha Iyengar, BS, MS, PhD; Jie Jin Wang, MMed, PhD

Arch Ophthalmol. 2009;127(10):1339-1344.

Objective  To determine whether complement factor H (CFH Y402H) genotype influences bilateral involvement of age-related macular degeneration (AMD) lesions.

Methods  The Blue Mountains Eye Study (BMES) followed up 3654 participants 49 years and older (BMES 1, 1992-1994), including 2335 (75.3% of survivors) at the 5-year (BMES 2, 1997-1999) and 1952 (76.5%) at the 10-year (BMES 3, 2002-2004) examinations. Age-related macular degeneration retinal photographic grading used the Wisconsin system. Early and late AMD included prevalent and incident cases from all visits. CFH genotyping used TaqMan assays.

Results  Of 767 AMD cases, 53.3% of early and 53.1% of late AMD cases were bilateral. After adjusting for age and other covariants, the CFH CC (Y402H polymorphism) genotype was associated with an increased likelihood of bilateral compared with unilateral involvement by any soft drusen (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.4-4.5), distinct soft drusen (OR, 2.8; 95% CI, 1.0-8.1), and pigmentary abnormalities (OR, 1.7; 95% CI, 1.0-2.8). We could not establish significant associations between this genotype and the bilaterality of late AMD (OR, 1.8; 95% CI, 0.4-7.7), either geographic atrophy (OR, 0.6; 95% CI, 0.07-4.6) or neovascular AMD (OR, 3.4; 95% CI, 0.3-41.4).

Conclusions  Persons with the CFH CC genotype at any given age have an increased likelihood of bilateral compared with unilateral involvement of some early AMD lesions.

Author Affiliations: Centre for Vision Research, Department of Ophthalmology, and Westmead Millennium Institute, University of Sydney, Sydney (Drs Pai, Mitchell, and Wang and Ms Rochtchina) and Retinal Vascular Imaging Centre, Centre for Eye Research Australia, Department of Ophthalmology, University of Melbourne, Melbourne (Dr Wang), Australia; and Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio (Dr Iyengar).

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