One thousand black African and 380 white Caucasian patients over the age of 50 were examined for evidence of age-related macular changes, namely, drusen, pigment epithelial atrophy, and disciform macular degeneration. Drusen and pigment epithelial changes were found to occur twice as commonly in Caucasians as in Africans; there was a much greater difference in the prevalence of disciform macular degeneration between the 2 groups. The cause of the differences remains unexplained.