Joint effects of meteorological factors and PM(2.5) on age-related macular degeneration: a national cross-sectional study in China

BACKGROUND: Weather conditions are a possible contributing factor to age-related macular degeneration (AMD), a leading cause of irreversible loss of vision. The present study evaluated the joint effects of meteorological factors and fine particulate matter (PM(2.5)) on AMD. METHODS: Data was extracted from a national cross-sectional survey conducted across 10 provinces in rural China. A total of 36,081 participants aged 40 and older were recruited. AMD was diagnosed clinically by slit-lamp ophthalmoscopy, fundus photography, and spectral domain optical coherence tomography (OCT). Meteorological data were calculated by European Centre for Medium-Range Weather Forecasts (ECMWF) reanalysis and were matched to participants’ home addresses by latitude and longitude. Participants’ individual PM(2.5) exposure concentrations were calculated by a satellite-based model at a 1-km resolution level. Multivariable-adjusted logistic regression models paired with interaction analysis were performed to investigate the joint effects of meteorological factors and PM(2.5) on AMD. RESULTS: The prevalence of AMD in the study population was 2.6% (95% CI 2.42–2.76%). The average annual PM(2.5) level during the study period was 63.1 ± 15.3 µg/m(3). A significant positive association was detected between AMD and PM(2.5) level, temperature (T), and relative humidity (RH), in both the independent and the combined effect models. For PM(2.5), compared with the lowest quartile, the odds ratios (ORs) with 95% confidence intervals (CIs) across increasing quartiles were 0.828 (0.674,1.018), 1.105 (0.799,1.528), and 2.602 (1.516,4.468). Positive associations were observed between AMD and temperature, with ORs (95% CI) of 1.625 (1.059,2.494), 1.619 (1.026,2.553), and 3.276 (1.841,5.830), across increasing quartiles. In the interaction analysis, the estimated relative excess risk due to interaction (RERI) and the attributable proportion (AP) for combined atmospheric pressure and PM(2.5) was 0.864 (0.586,1.141) and 1.180 (0.768,1.592), respectively, indicating a synergistic effect between PM(2.5) and atmospheric pressure. CONCLUSIONS: This study is among the first to characterize the coordinated effects of meteorological factors and PM(2.5) on AMD. The findings warrant further investigation to elucidate the relationship between ambient environment and AMD. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at https://doi.org/10.1265/ehpm.22-00237.