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Racial differences may influence prevalence, progression of AMD, study suggests

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White individuals may be more likely than black individuals to develop medium or large drusen and focal pigment abnormalities associated with advanced age-related macular degeneration, according to a population-based study by researchers in Maryland.

Additionally, racial differences appear to persist for non-neovascular AMD only within the central 1,500 µm of the macula, the study authors reported.

“These data suggest that black individuals may have a mechanism for protection in the central zone against these critical fundus features, which themselves convey high risk of progression to advanced AMD,” the authors said.

Susan B. Bressler, MD, and colleagues at Johns Hopkins University School of Medicine, Baltimore, graded stereoscopic color fundus photographs obtained for 2,520 participants who averaged 73.5 years of age. The researchers examined differences in the prevalence of AMD and its associated drusen and pigment epithelium abnormalities between older black and white participants. Specifically, 1,854 participants were white and 666 were black, according to the study.

The researchers identified drusen of at least 64 µm in size in 56% of black and white participants within 3,000 µm of the foveal center. However, drusen larger than 125 µm were more prevalent among white participants (16%) than black participants (11%).

The prevalence of drusen of at least 250 µm in size, confluent drusen or drusen more than 10% larger were each more common among white participants, according to the study.

White individuals were also three times more likely to have focal hyperpigmentation.

“Racial differences were most pronounced for features within the central 1,500-µm macular zone,” the authors said.

Neovascular AMD was present in 1.7% of white participants and 1.1% of black participants (P = .38). Geographic atrophy was also more prevalent in white (1.8%) than in black (0.3%) participants (P = .02), they noted.

The study is published in the February issue of Archives of Ophthalmology.