Elsevier

Ophthalmology

Volume 118, Issue 4, April 2011, Pages 694-699
Ophthalmology

Original article
Prevalence and Risk Factors for Epiretinal Membranes in a Multi-Ethnic United States Population

https://doi.org/10.1016/j.ophtha.2010.08.009Get rights and content

Purpose

To describe the prevalence of and risk factors for epiretinal membrane (ERM) in a multi-ethnic population and to evaluate possible racial or ethnic differences.

Design

Cross-sectional study.

Participants

Participants of the Multi-Ethnic Study of Atherosclerosis (MESA), examined at the second visit of the MESA when retinal photography was performed.

Methods

Data on 5960 participants aged 45 to 84 years from MESA, including white, black, Hispanic, and Chinese persons from 6 United States communities, were analyzed. Epiretinal membrane was assessed from digital nonstereoscopic fundus photographs and was defined as cellophane macular reflex (CMR) without retinal folds or preretinal macular fibrosis (PMF) with retinal folds. Risk factors were assessed from standardized interviews, clinical examinations, and laboratory investigations.

Main Outcome Measures

Epiretinal membrane prevalence by ethnic or racial group and risk factors associated with ERM.

Results

The prevalence of any ERM was 28.9%, of which 25.1% were CMR cases and 3.8% were PMF cases. The prevalence of ERM was significantly higher in Chinese persons (39.0%), compared with Hispanic (29.3%), white (27.5%), or black (26.2%; P<0.001) persons. In multivariate models, increasing age (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.06–1.34, per year increase in age), diabetes (OR, 1.92; 95% CI, 1.39–2.65), and hypercholesterolemia (OR, 1.33; 95% CI, 1.04–1.69) were significantly associated with CMR.

Conclusions

This study showed that ERM was significantly more common in Chinese persons compared with whites, blacks, and Hispanics. Risk factors for ERM were increasing age, presence of diabetes, and hypercholesterolemia.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Section snippets

Study Population

The Multi-Ethnic Study of Atherosclerosis (MESA) is a prospective cohort study of men and women 45 to 84 years of age without a history of clinical cardiovascular disease sampled from 6 United States communities. Details of the methodology have been described elsewhere.11, 12, 13, 14 In brief, a total of 6814 recruited participants underwent a baseline examination (July 2000 through August 2002). Of these, 6176 returned for a second examination and had retinal photographs taken (August 2002

Participants

The MESA participant characteristics have been presented previously.14, 16 In summary, from 6814 participants recruited at baseline, 6176 participated in the follow-up visit, when retinal images were obtained. Of 6176 participants, 5960 had gradable photographs for ERM. Of the 5960 participants, 39% were white, 27% were black, 22% were Hispanic, and 12% were Chinese. The mean age of participants was 63.2 years (whites, 63.8 years; Chinese, 63.2 years; blacks, 63.0 years; Hispanics, 62.4 years;

Discussion

This study found a nearly 28.9% prevalence of ERM in the MESA population (age-standardized prevalence, 22.7%; 95% confidence interval, 21.5%–23.8%), substantially higher than previously reported in any other study (see Table 4, available at http://aaojournal.org). Other population studies have reported prevalence rates ranging from 6.0% to 11.8% in whites,1, 2, 5 18.0% in Hispanics,4 2.2% to 3.0% in Chinese persons, 4.0% to 5.4% in Japanese persons,6, 9 and 7.9% in Malays.8 To the authors'

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Manuscript no. 2009-1402.

Supported by the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland (grant nos.: N01-HC-95159 through N01-HC-95165 and N01-HC-95169); the National Institutes of Health, Bethesda, Maryland (grant no.: HL69979-03 [RK and TYW); and the National Eye Institute, National Institutes of Health, Bethesda, Maryland (grant no.: Z01EY000403 [MFC]). The funding source had no role in the design or conduct of this research.

Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

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