Age- and sex-based evaluation of the association between refractive error and age-related macular degeneration in the Korean population

PURPOSE: The aim of this study was to investigate the association between refractive error and prevalence of age-related macular degeneration (AMD) in Korean adults, based on the sex and age group. METHODS: This was a nationwide population-based cross-sectional study that included 17,676 subjects aged over 40 years who participated in the 2008–2012 Korean National Health and Nutrition Examination Survey. Digital fundus images (45°) were obtained for both eyes under physiologic mydriasis and were graded using the international classification and grading system for age-related macular degeneration. The spherical equivalents of refractive errors were calculated in diopters using auto-refraction data. RESULTS: After adjustment for potential confounders, myopia was associated with lower risk of any age-related macular degeneration [odds ratio (OR), 0.74; 95% Confidence Interval (CI), 0.61–0.91]. In particular, myopia was significantly associated with lower odds of age-related macular degeneration in female participants (any AMD: OR, 0.71; 95% CI, 0.54–0.93; early AMD: OR, 0.70; 95% CI, 0.53–0.93) and in participants younger than 50 years (any AMD: OR, 0.46; 95% CI, 0.24–0.90; early AMD: OR, 0.47; 95% CI, 0.24–0.93). There was no significant association between myopia and age-related macular degeneration in male participants and in participants older than 50 years. CONCLUSIONS: In the Korean adult population, myopia was associated with significantly lower odds of any type of early age-related macular degeneration, particularly in females and in younger age groups.