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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.

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