Prevalence and Pattern of Geographic Atrophy in Asia: The Asian Eye Epidemiology Consortium

Tyler Hyungtaek Rim, Ryo Kawasaki, Yih Chung Tham, Se Woong Kang, Paisan Ruamviboonsuk, Mukharram M. Bikbov, Masahiro Miyake, Jie Hao, Astrid Fletcher, Mariko Sasaki, Vinay Nangia, Charumathi Sabanayagam, Marco Yu, Kohta Fujiwara, Raba Thapa, Ian Y. Wong, Takamasa Kayama, Shih Jen Chen, Tung Mei Kuang, Hidetoshi YamashitaPeriasamy Sundaresan, Jonathan C. Chan, G. H.M.B. van Rens, Koh Hei Sonoda, Ya Xing Wang, Songhomitra Panda-Jonas, Sei Harada, Ramasamy Kim, Suganeswari Ganesan, Rajiv Raman, Kenji Yamashiro, Timur R. Gilmanshin, Watanee Jenchitr, Kyu Hyung Park, Chui Ming Gemmy Cheung, Tien Yin Wong, Ningli Wang, Jost B. Jonas, Usha Chakravarthy, Ching Yu Cheng*, Yasuo Yanagi, Asian Eye Epidemiology Consortium

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: Although there have been many population-based studies of age-related macular degeneration (AMD), only limited information is available in Asia on the epidemiology of geographic atrophy (GA). We aimed to determine the prevalence and patterns of GA through an analysis of multiple studies conducted within the Asian Eye Epidemiology Consortium (AEEC). Design: Cross-sectional meta-analyses. Participants: A total of 97 213 individuals aged 40 years and older. Methods: Data from 22 population-based studies from countries belonging to the AEEC were included. In all studies, AMD was defined on the basis of standardized grading systems. Geographic atrophy was defined as an area of pallor in the fundus with visibility of the underlying choroidal blood vessels and sharply defined borders. Random-effects meta-analysis was performed to estimate overall and age-, gender-, and region-specific pooled prevalence of GA. Main Outcome Measures: Prevalence of GA per 1000 persons. Results: The mean age was 60.8 ± 10.0 years, and 42 673 (43.9%) were male. Overall, a total of 223 individuals (0.2%) had GA. The pooled overall prevalence of GA was 1.57 per 1000 persons (95% confidence interval [CI], 1.04–2.10), which was 3 times less than that of neovascular AMD of 5.20 per 1000 persons (95% CI, 3.97–6.43). Compared with those aged 50 to 59 years, the prevalence of GA increased from 0.34 per 1000 persons (95% CI, 0.07–0.62) to 2.90 per 1000 persons (95% CI, 1.55–4.25) in those aged ≥70 years. The GA prevalence per 1000 persons was similar between urban (2.22; 95% CI, 1.22–3.23) and rural residents (1.33; 95% CI, 0.70–1.96). Geographic atrophy was more prevalent in South Asia (based on studies from India and Nepal, 3.82 per 1000 persons; 95% CI, 1.72–5.93) compared with East Asia (based on studies from China, Korea, Hong Kong, Taiwan, and Japan, and the Singapore Chinese Eye Study, 0.76 per 1000 persons; 95% CI, 0.31–1.22, P = 0.005). Conclusions: Geographic atrophy is uncommon in Asian populations compared with those of European ancestry. Even within Asia, geographic differences in GA prevalence were seen. The findings of this meta-analysis suggest that better dissection of risk factors in the Asian population for GA may provide insights into the biological pathways that drive these late-stage manifestations, thus suggesting better targets for prevention.

Original languageEnglish
Pages (from-to)1371-1381
Number of pages11
JournalOphthalmology
Volume127
Issue number10
DOIs
Publication statusPublished - Oct 2020

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