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. 2000;98:109–117.

Race, iris color, and age-related macular degeneration.

R N Frank 1, J E Puklin 1, C Stock 1, L A Canter 1
PMCID: PMC1298217  PMID: 11190014

Abstract

PURPOSE: While most observers agree that age-related macular degeneration (AMD) is much more common in white persons than in persons of black African ancestry, the influence of iris color has been more controversial. We reexamined relationships between race, iris color, and AMD in a series of patients from our retina clinic. METHODS: We evaluated, in masked fashion, stereoscopic photographs of the retinas and irides in 306 sequential patients 60 years of age or older from our retina clinics. Four readers judged whether AMD was present, absent, or questionable in the retinal photographs and labeled iris color as blue, hazel, or brown. Presence or absence of AMD and presence and severity of the various macular lesions were determined by "majority vote" of the readers. We evaluated inter-rater agreement using the kappa statistic. We compared the prevalence of AMD and of specific AMD lesions as a function of race, sex, and iris color by contingency table analysis. RESULTS: The kappa statistic showed good inter-observer agreement, being 0.466 (P < 10(-6)) for definite or questionable AMD and ranging from 0.185 to 0.522 (P = 0.0047 to P < 10(-6)) for most lesions. We found significantly more AMD in white patients than in black patients (X2 = 27.54, P < 10(-4)). There was no significant difference in AMD prevalence by sex. In white patients, AMD was significantly more prevalent in individuals with blue or hazel irides than in those with brown irides (X2 = 15.04, P = .02). CONCLUSIONS: We confirm previous findings of a higher prevalence of AMD in white persons than in black persons. We also agree with those observers who claim that white subjects with light-colored irides have a higher prevalence of AMD than those with dark-colored irides. We suggest that differences in the association between iris pigmentation and AMD in different studies using different research methods may reflect genetic difference in the groups being studied.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bird A. C., Bressler N. M., Bressler S. B., Chisholm I. H., Coscas G., Davis M. D., de Jong P. T., Klaver C. C., Klein B. E., Klein R. An international classification and grading system for age-related maculopathy and age-related macular degeneration. The International ARM Epidemiological Study Group. Surv Ophthalmol. 1995 Mar-Apr;39(5):367–374. doi: 10.1016/s0039-6257(05)80092-x. [DOI] [PubMed] [Google Scholar]
  2. Bressler S. B., Bressler N. M., Seddon J. M., Gragoudas E. S., Jacobson L. P. Interobserver and intraobserver reliability in the clinical classification of drusen. Retina. 1988;8(2):102–108. doi: 10.1097/00006982-198808020-00004. [DOI] [PubMed] [Google Scholar]
  3. Cruickshanks K. J., Hamman R. F., Klein R., Nondahl D. M., Shetterly S. M. The prevalence of age-related maculopathy by geographic region and ethnicity. The Colorado-Wisconsin Study of Age-Related Maculopathy. Arch Ophthalmol. 1997 Feb;115(2):242–250. doi: 10.1001/archopht.1997.01100150244015. [DOI] [PubMed] [Google Scholar]
  4. Frank R. N., Hoffman W. H., Podgor M. J., Joondeph H. C., Lewis R. A., Margherio R. R., Nachazel D. P., Jr, Weiss H., Christopherson K. W., Cronin M. A. Retinopathy in juvenile-onset diabetes of short duration. Ophthalmology. 1980 Jan;87(1):1–9. doi: 10.1016/s0161-6420(80)35282-2. [DOI] [PubMed] [Google Scholar]
  5. Friedman D. S., Katz J., Bressler N. M., Rahmani B., Tielsch J. M. Racial differences in the prevalence of age-related macular degeneration: the Baltimore Eye Survey. Ophthalmology. 1999 Jun;106(6):1049–1055. doi: 10.1016/S0161-6420(99)90267-1. [DOI] [PubMed] [Google Scholar]
  6. Gibson J. M., Shaw D. E., Rosenthal A. R. Senile cataract and senile macular degeneration: an investigation into possible risk factors. Trans Ophthalmol Soc U K. 1986;105(Pt 4):463–468. [PubMed] [Google Scholar]
  7. Gorin M. B., Breitner J. C., De Jong P. T., Hageman G. S., Klaver C. C., Kuehn M. H., Seddon J. M. The genetics of age-related macular degeneration. Mol Vis. 1999 Nov 3;5:29–29. [PubMed] [Google Scholar]
  8. Holz F. G., Piguet B., Minassian D. C., Bird A. C., Weale R. A. Decreasing stromal iris pigmentation as a risk factor for age-related macular degeneration. Am J Ophthalmol. 1994 Jan 15;117(1):19–23. doi: 10.1016/s0002-9394(14)73010-7. [DOI] [PubMed] [Google Scholar]
  9. Jampol L. M., Tielsch J. Race, macular degeneration, and the Macular Photocoagulation Study. Arch Ophthalmol. 1992 Dec;110(12):1699–1700. doi: 10.1001/archopht.1992.01080240039024. [DOI] [PubMed] [Google Scholar]
  10. Klein R., Clegg L., Cooper L. S., Hubbard L. D., Klein B. E., King W. N., Folsom A. R. Prevalence of age-related maculopathy in the Atherosclerosis Risk in Communities Study. Arch Ophthalmol. 1999 Sep;117(9):1203–1210. doi: 10.1001/archopht.117.9.1203. [DOI] [PubMed] [Google Scholar]
  11. Klein R., Klein B. E., Jensen S. C., Cruickshanks K. J. The relationship of ocular factors to the incidence and progression of age-related maculopathy. Arch Ophthalmol. 1998 Apr;116(4):506–513. doi: 10.1001/archopht.116.4.506. [DOI] [PubMed] [Google Scholar]
  12. Klein R., Klein B. E., Jensen S. C., Mares-Perlman J. A., Cruickshanks K. J., Palta M. Age-related maculopathy in a multiracial United States population: the National Health and Nutrition Examination Survey III. Ophthalmology. 1999 Jun;106(6):1056–1065. doi: 10.1016/S0161-6420(99)90255-5. [DOI] [PubMed] [Google Scholar]
  13. Klein R., Klein B. E., Jensen S. C., Mares-Perlman J. A., Cruickshanks K. J., Palta M. Age-related maculopathy in a multiracial United States population: the National Health and Nutrition Examination Survey III. Ophthalmology. 1999 Jun;106(6):1056–1065. doi: 10.1016/S0161-6420(99)90255-5. [DOI] [PubMed] [Google Scholar]
  14. Mitchell P., Smith W., Wang J. J. Iris color, skin sun sensitivity, and age-related maculopathy. The Blue Mountains Eye Study. Ophthalmology. 1998 Aug;105(8):1359–1363. doi: 10.1016/S0161-6420(98)98013-7. [DOI] [PubMed] [Google Scholar]
  15. Mitchell P., Smith W., Wang J. J. Iris color, skin sun sensitivity, and age-related maculopathy. The Blue Mountains Eye Study. Ophthalmology. 1998 Aug;105(8):1359–1363. doi: 10.1016/S0161-6420(98)98013-7. [DOI] [PubMed] [Google Scholar]
  16. Rohan R. M., Fernandez A., Udagawa T., Yuan J., D'Amato R. J. Genetic heterogeneity of angiogenesis in mice. FASEB J. 2000 May;14(7):871–876. doi: 10.1096/fasebj.14.7.871. [DOI] [PubMed] [Google Scholar]
  17. Sandberg M. A., Gaudio A. R., Miller S., Weiner A. Iris pigmentation and extent of disease in patients with neovascular age-related macular degeneration. Invest Ophthalmol Vis Sci. 1994 May;35(6):2734–2740. [PubMed] [Google Scholar]
  18. Schachat A. P., Hyman L., Leske M. C., Connell A. M., Wu S. Y. Features of age-related macular degeneration in a black population. The Barbados Eye Study Group. Arch Ophthalmol. 1995 Jun;113(6):728–735. doi: 10.1001/archopht.1995.01100060054032. [DOI] [PubMed] [Google Scholar]
  19. Schachat A. P., Hyman L., Leske M. C., Connell A. M., Wu S. Y. Features of age-related macular degeneration in a black population. The Barbados Eye Study Group. Arch Ophthalmol. 1995 Jun;113(6):728–735. doi: 10.1001/archopht.1995.01100060054032. [DOI] [PubMed] [Google Scholar]
  20. Schatz H. The senile maculopathies and the retinal pigment epithelium. Int Ophthalmol Clin. 1975 Spring;15(1):169–180. doi: 10.1097/00004397-197501510-00014. [DOI] [PubMed] [Google Scholar]
  21. Schraermeyer U., Heimann K. Current understanding on the role of retinal pigment epithelium and its pigmentation. Pigment Cell Res. 1999 Aug;12(4):219–236. doi: 10.1111/j.1600-0749.1999.tb00755.x. [DOI] [PubMed] [Google Scholar]
  22. Schwartz D. The Beaver Dam Eye Study: the relation of age-related maculopathy to smoking. Surv Ophthalmol. 1994 Jul-Aug;39(1):84–85. [PubMed] [Google Scholar]
  23. Seddon J. M., Ajani U. A., Sperduto R. D., Hiller R., Blair N., Burton T. C., Farber M. D., Gragoudas E. S., Haller J., Miller D. T. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. JAMA. 1994 Nov 9;272(18):1413–1420. [PubMed] [Google Scholar]
  24. Seddon J. M., Willett W. C., Speizer F. E., Hankinson S. E. A prospective study of cigarette smoking and age-related macular degeneration in women. JAMA. 1996 Oct 9;276(14):1141–1146. [PubMed] [Google Scholar]
  25. Sommer A., Tielsch J. M., Katz J., Quigley H. A., Gottsch J. D., Javitt J. C., Martone J. F., Royall R. M., Witt K. A., Ezrine S. Racial differences in the cause-specific prevalence of blindness in east Baltimore. N Engl J Med. 1991 Nov 14;325(20):1412–1417. doi: 10.1056/NEJM199111143252004. [DOI] [PubMed] [Google Scholar]
  26. Taylor H. R., West S., Muñoz B., Rosenthal F. S., Bressler S. B., Bressler N. M. The long-term effects of visible light on the eye. Arch Ophthalmol. 1992 Jan;110(1):99–104. doi: 10.1001/archopht.1992.01080130101035. [DOI] [PubMed] [Google Scholar]
  27. Vinding T. Pigmentation of the eye and hair in relation to age-related macular degeneration. An epidemiological study of 1000 aged individuals. Acta Ophthalmol (Copenh) 1990 Feb;68(1):53–58. doi: 10.1111/j.1755-3768.1990.tb01649.x. [DOI] [PubMed] [Google Scholar]
  28. Vinding T. Pigmentation of the eye and hair in relation to age-related macular degeneration. An epidemiological study of 1000 aged individuals. Acta Ophthalmol (Copenh) 1990 Feb;68(1):53–58. doi: 10.1111/j.1755-3768.1990.tb01649.x. [DOI] [PubMed] [Google Scholar]
  29. Vingerling J. R., Hofman A., Grobbee D. E., de Jong P. T. Age-related macular degeneration and smoking. The Rotterdam Study. Arch Ophthalmol. 1996 Oct;114(10):1193–1196. doi: 10.1001/archopht.1996.01100140393005. [DOI] [PubMed] [Google Scholar]
  30. Weiter J. J., Delori F. C., Wing G. L., Fitch K. A. Relationship of senile macular degeneration to ocular pigmentation. Am J Ophthalmol. 1985 Feb 15;99(2):185–187. doi: 10.1016/0002-9394(85)90230-2. [DOI] [PubMed] [Google Scholar]
  31. West S. K., Rosenthal F. S., Bressler N. M., Bressler S. B., Munoz B., Fine S. L., Taylor H. R. Exposure to sunlight and other risk factors for age-related macular degeneration. Arch Ophthalmol. 1989 Jun;107(6):875–879. doi: 10.1001/archopht.1989.01070010897038. [DOI] [PubMed] [Google Scholar]
  32. West S., Vitale S., Hallfrisch J., Muñoz B., Muller D., Bressler S., Bressler N. M. Are antioxidants or supplements protective for age-related macular degeneration? Arch Ophthalmol. 1994 Feb;112(2):222–227. doi: 10.1001/archopht.1994.01090140098031. [DOI] [PubMed] [Google Scholar]

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