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Education, Socioeconomic Status and Age-related Macular Degeneration in Asians: The Singapore Malay Eye Study
  1. Peter Cackett (pdcackett{at},
  2. Wan Ting Tay (tay.wan.ting{at},
  3. Tin Aung (aung_tin{at},
  4. Jie Jin Wang (jiejin_wang{at},
  5. Anoop Shankar (ashankar{at},
  6. Seang-Mei Saw (cofsawsm{at},
  7. Paul R Mitchell (paul_mitchell{at},
  8. Tien Yin Wong (twong{at}
  1. Singapore National Eye Centre, Singapore
  2. Singapore Eye Research Institute, Singapore
  3. Singapore Eye Research Institute, Singapore
  4. Centre for Vision Research, University of Sydney, Australia
  5. National University of Singapore, Singapore
  6. National University of Singapore, Singapore
  7. University of Sydney, Australia
  8. University of Melbourne, Australia


    Background/Aims: Low socioeconomic status is increasingly being identified as a risk marker for chronic diseases, but few studies have investigated the link between socioeconomic factors and age-related macular degeneration (AMD). The present study aimed to assess the association between socioeconomic status and the prevalence of AMD.

    Methods: A population-based cross-sectional study of 3,280 (78.7% response rate) Malay adults aged 40-80 years residing in 15 south-western districts of Singapore. AMD was graded from retinal photographs at a central reading centre using the modified Wisconsin AMD scale. Early and late AMD signs were graded from retinal photographs following the Wisconsin grading system. Socioeconomic status including education, housing type and income were determined from a detailed interview.

    Results: Of the participants, 3,265 had sufficient quality photographs for grading of AMD. Early AMD was present in 160 (4.9%) and late AMD in 23 (0.70%). After adjusting for age, gender, smoking, hypertension, diabetes and body mass index, participants with lower educational levels were significantly more likely to have early AMD (multivariate OR 2.2, 95% confidence intervals, 1.2-4.0). This association was stronger in persons who had never smoked (multivariate OR 3.6, 95% confidence intervals, 1.4-9.4). However, no association with housing type or income was seen.

    Conclusions: Low educational level is associated with a higher prevalence of early AMD signs in our Asian population, independent of age, cardiovascular risk factors and cigarette smoking.

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