Smoking, Alcohol Intake, Estrogen Use, and Age-related Macular Degeneration in Latinos: The Los Angeles Latino Eye Study
Accepted 5 August 2005. published online 31 October 2005.
Purpose
To assess the association between smoking, alcohol intake, estrogen use, and both early age-related macular degeneration (AMD) (soft indistinct drusen, retinal pigment abnormalities) and advanced AMD (exudative AMD, geographic atrophy) in the Latino community.
Design
Population-based, cross-sectional study.
Methods
Complete ophthalmic examination included stereoscopic macular photographs graded with a modified Wisconsin Age-related Maculopathy Grading System. A history of smoking, alcohol intake, and exogenous estrogen use was obtained by interview. Logistic regression was performed, and odds ratios (OR) were calculated with each AMD lesion as a dependent variable.
Results
There were 5875 participants (92.4%) with gradable photographs. Having ever smoked was associated with a higher risk of having advanced AMD (OR, 2.4). Heavy consumption of alcohol (>5 drinks per session) was significantly associated with a greater risk of having exudative AMD (OR, 5.8) and geographic atrophy (OR, 12.7) Beer drinking was associated with a higher risk of having advanced AMD (OR, 2.9), whereas wine drinking appeared to be protective for increased retinal pigment (OR, 0.7). Exogenous estrogen use also appeared to be protective from soft indistinct drusen (OR, 0.5) and increased retinal pigment (OR, 0.6), but power was limited in the assessment of its association with advanced AMD.
Conclusion
Smoking and heavy alcohol consumption, particularly beer, was associated with a greater risk of having advanced AMD; exogenous estrogen use appeared to have a weak protective effect in Latino participants. Similar modifiable risk factors have been identified previously in non-Hispanic white patients, which suggests that common pathogenic mechanisms may be associated with AMD in persons of different ethnicities.
aDepartment of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
bDepartment of Pharmaceutical Economics and Policy, School of Pharmacy, University of Southern California, Los Angeles, California
cDepartment of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin
dDoheny Eye Institute and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California
eLos Angeles Latino Eye Study Group (see Appendix)
Inquiries to Rohit Varma MD, MPH, Doheny Eye Institute, Suite 4900, 1450 San Pablo Street, Los Angeles, CA 90033; fax: 323–446–6412
Supported by grants EY-11753 and EY-03040 from the National Eye Institute and the National Center on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, and an unrestricted grant from Research to Prevent Blindness, New York, NY. Rohit Varma is a Research to Prevent Blindness Sybil B. Harrington Scholar.
ABSTRACT