Age-Related Macular Degeneration: Prevalence and Risk Factors from Korean National Health and Nutrition Examination Survey, 2008 through 2011

Objective To investigate the prevalence and risk factors of age-related macular degeneration (AMD) in the Korean population. Design A cross-sectional study using a complex, stratified, multistage, probability-cluster survey, which can produce nationally representative estimates. Participants Using the database of Korean National Health and Nutrition Examination Survey from 2008 through 2011, 14 352 participants 40 years of age or older with gradable fundus photographs were included. Methods Age-related macular degeneration was determined by fundus photograph. Prevalences of AMDs were estimated. Risk factor analyses were conducted using logistic regression analyses (LRAs). Main Outcome Measures Prevalence and risk factors of AMD. Results The prevalence of AMD was 6.62% (95% confidence interval [CI], 6.15%–7.09%) in the Korean population: 6.02% (95% CI, 5.56%–6.48%) were early AMD and 0.60% (95% CI, 0.45%–0.75%) were late AMD. The prevalence of early AMD in women (6.73%; 95% CI, 6.11%–7.35%) was higher than that in men (5.25%; 95% CI, 4.61%–5.89%; P P P P  = 0.027), occupation ( P P  = 0.027), hepatitis B surface antigen carrier status ( P P  = 0.032; waist circumference, P  = 0.041, in separate analyses), and higher serum high-density lipoprotein (HDL) level ( P  = 0.046), but not with smoking status. Late AMD had positive associations with age groups ( P P  = 0.022), and lower BMI ( P  = 0.037). Conclusions The results suggest that there are 1.21 million individuals with early AMD and 121 000 individuals with late AMD in Korea. Nonoverweight status and higher HDL levels, generally assumed as positive health indicators, as well as anemia and hepatitis B infection had harmful associations with AMD in our study, implying a possible different pathophysiologic process of AMD in Asians compared with that of white persons.