Refractive errors and age-related macular degeneration: A systematic review and meta-analysis

Chen Wei Pan, M. Kamran Ikram, Carol Y. Cheung, Hyung Won Choi, Chiu Ming Gemmy Cheung, Jost B. Jonas, Seang Mei Saw, Tien Yin Wong*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

41 Citations (Scopus)


Objective: To evaluate the association between refractive errors and age-related macular degeneration (AMD). Main Outcome Measures: A clear understanding of the relationship between refractive error and AMD provides insights into the pathophysiology of AMD. Methods: We searched PubMed and Embase from their inception to July 2012 for population-based studies with data on refractive error and AMD assessed from retinal photographs at baseline and follow-up. We performed separate meta-analyses for cross-sectional studies and cohort studies using adjusted odds ratios (ORs) and hazard ratios (HRs) under random effects models, respectively. Results: Analysis of the 6 cross-sectional studies showed that hyperopia was associated with higher odds of prevalent AMD (pooled OR hyperopia vs. emmetropia: 1.16; 95% confidence interval [CI], 1.04-1.29) and that myopia was associated with lower odds of prevalent AMD (pooled OR myopia vs. emmetropia: 0.75; 95% CI, 0.61-0.92). Analysis from the 3 cohort studies showed nonsignificant associations. Analysis of the 5 cross-sectional and 2 cohort studies showed that each diopter increase in spherical equivalent was associated with increased odds of both prevalent (pooled OR, 1.09; 95% CI, 1.06-1.12) and incident (pooled HR, 1.06; 95% CI, 1.02-1.10) AMD. In 3 cross-sectional studies with data on axial length, each millimeter increase in axial length was associated with a decreased odd of prevalent AMD (pooled OR, 0.76; 95% CI, 0.69-0.85). Conclusions: Refractive error is associated with AMD, although a temporal relationship cannot be determined on the basis of current evidence. Ophthalmologists should be aware that risk of AMD clinically seems to vary by refractive status. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Original languageEnglish
Pages (from-to)2058-2065
Number of pages8
Issue number10
Publication statusPublished - Oct 2013
Externally publishedYes

Bibliographical note

Funding Information:
This study was funded by the Biomedical Research Council , 08/1/35/19/550 , and National Medical Research Council , STaR/0003/2008 , Singapore.


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