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Racial Differences in Macular Degeneration: African Americans

Macular degeneration is currently the leading cause of vision loss in America. It affects more than 10 million people – more than cataracts and glaucoma combined.1

Macular degeneration does not affect all groups of people at the same rate. It affects Caucasians more than African-Americans or people of Hispanic/Latino background. There may also be genetic differences that underpin the disease for people with different ethnic origins.1

This article covers general information about macular degeneration as well as what we know about this disease among African-Americans.

How does macular degeneration develop?

The retina is a thin layer of light-sensitive cells at the back of the eye. It is responsible for receiving light energy through the pupil and transforming that energy into signals that go to the brain. This is the basic process that enables us to see.

Macular degeneration happens when the central part of your retina, called the macula, is damaged. This leads to impaired vision, particularly in the center of your eye. This is the area responsible for your ability to read, drive, recognize faces, and see fine detail.1

About 80 percent of people with macular degeneration have what’s known as dry AMD. In dry AMD, you develop small clumps of fatty, yellow-looking cells in the back of the eye. These clumps are called drusen.2 Over time, drusen can grow and cause more damage to your vision.

What is age-related macular degeneration?

Although macular degeneration can develop in children and teens, by far the most cases of the disease occur in people over 50. That’s why the condition is frequently known as age-related macular degeneration, or AMD.3

Different numbers among ethnic groups

In the United States, white Americans had the highest chance of developing AMD. As of 2010, 2.5 percent of white adults over 50 had AMD.

The numbers are lower for people with different ethnic backgrounds4:

  • Caucasians: 2.5 percent
  • African-Americans: 0.9 percent
  • Latino/Hispanic: 0.9 percent
  • Other: 0.9 percent

The difference is even greater when you look at AMD by age 804:

  • Caucasians: 14 percent
  • African-Americans: 2 percent
  • Latino/Hispanic: 2 percent
  • Other: 2 percent

Macular degeneration in African-Americans

Most studies have looked at European Caucasians to understand AMD – how often it develops, how it looks when it worsens, and common genetic risk factors.

More recent research is starting to look at the disease in African-Americans specifically.

Key differences include5:

  • AMD is less common among older African-Americans than Caucasians.
  • African-Americans are less likely to develop larger drusen.
  • Fewer large drusen appear in the central part of the eye for African-Americans.
  • Only 36 percent of drusen appear in the central part of the eye for African-Americans, compared to 61 percent for Caucasians.
  • African-Americans are less likely than Caucasians to have their drusen grow from medium to large, a measure of the disease progressing, or getting worse.6

Because of these differences, researchers wonder if African-Americans may have protection against vision loss and AMD.

African-American genetics and AMD

Researchers at Vanderbilt University are currently attempting to conduct genetic studies on older African-Americans with AMD to see if they have the same or different genetic risk factors as Caucasians. If different genes are at play, researchers may learn important clues about preventing or treating the disease.7

Contribute to a better understanding!

We want to hear from you! Help us better understand these differences and what life might look like for you as an African American with macular degeneration by taking our 2nd Annual Macular Degeneration In America survey below.

  1. What is Macular Degeneration? American Macular Degeneration Foundation. Available at https://www.macular.org/what-macular-degeneration. Accessed 11/18/19.
  2. What is the Retina? VMR Institute. Available at https://www.vmrinstitute.com/what-is-the-retina/. Accessed 10/29/19.
  3. Boyd, K. What is Macular Degeneration? American Academy of Ophthalmology. Available at https://www.aao.org/eye-health/diseases/amd-macular-degeneration. Accessed 10/29/19.
  4. Age-Related Macular Degeneration (AMD) Data and Statistics. National Eye Institute. Available at https://www.nei.nih.gov/learn-about-eye-health/resources-for-health-educators/eye-health-data-and-statistics/age-related-macular-degeneration-amd-data-and-statistics. Accessed 11/18/19.
  5. Sadigh, S., Luo, X., Cideciyan, A., et al. Drusen and Photoreceptor Abnormalities in African-Americans with Intermediate Non-neovascular Age-related Macular Degeneration. Curr Eye Res. 2015 Apr; 40(4): 398–406. Accessed 11/18/19.
  6. Chang, M., Bressler, S., Munoz, B., et al. Racial Differences and Other Risk Factors for Incidence and Progression of Age-Related Macular Degeneration: Salisbury Eye Evaluation (SEE) Project. Investigative Ophthalmology & Visual Science June 2008, Vol.49, 2395-2402. doi: https://doi.org/10.1167/iovs.07-1584. Accessed 11/18/19.
  7. Haines, J. and Agarwal, A. The Genetics of Age-Related Macular Degeneration in African-Americans. BrightFocus Foundation. Available at https://www.brightfocus.org/macular/grant/genetics-amd-african-americans. Accessed 11/18/19.

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