Abstract
In order to investigate the influence of season and month of birth on the risk of neovascular age-related macular degeneration (n-AMD) in Italy, we evaluated the month birth and sex of all patients, recorded in the anti-vascular endothelial growth factor (VEGF) monitoring registry of the Italian Medicines Agency, born between 1925–1944, who received intravitreal anti-VEGF injections for n-AMD between January 1, 2013 and July 29, 2015. The numbers of all births in Italy in the same years, extracted from the Italian National Institute of Statistics, were used to calculate the expected number of n-AMD cases. Overall, 45,845 patients (19,207 men, 26,638 women) received intravitreal anti-VEGF for n-AMD; in the same years, 20,140,426 people (10,334,262 male, 9,806,164 female) were born in Italy. Comparing the observed number of n-AMD cases with the expected number of n- AMD cases in each season, we found that the season-specific risk for n-AMD was 2.5% higher for those born in summer (OR=1.03, Bonferroni-corrected P=0.008) and 3% lower for those born in winter (OR=0.96, Bonferroni-corrected P=0.0004). When considering the month of birth, the risk of n-AMD was 5.9% lower for people born in January (OR=0.93, Bonferroni-corrected P=0.0012). The factors causing such differences should be determined.
Highlights
Age-related macular degeneration (AMD), a progressive chronic disease of the central retina, is a major cause of blindness worldwide [1]
Comparing the observed number of neovascular age‐related macular degeneration (n‐AMD) cases with the expected number of n‐ AMD cases in each season, we found that the season‐specific risk for n‐AMD was 2.5% higher for those born in summer (OR=1.03, Bonferroni‐corrected P=0.008) and 3% lower for those born in winter (OR=0.96, Bonferroni‐corrected P=0.0004)
A total of 46,826 patients born in these years were treated with anti-VEGF; after excluding 981 patients born outside Italy, a final sample of 45,845 patients (19,207 men and 26,638 women) who were born in Italy and treated with intravitreal anti-VEGF for neovascular AMD (n-AMD) was obtained
Summary
Age-related macular degeneration (AMD), a progressive chronic disease of the central retina, is a major cause of blindness worldwide [1]. The prevalence of AMD is likely to increase as a consequence of the exponential increase in the aging population, and the projected number of people with AMD in 2040 is around 288 million [2]. AMD will be a major medical and socioeconomic challenge worldwide in the coming years. The precise pathogenesis is still poorly understood. It is generally accepted that AMD is the result of a complex interaction between genetic and environmental factors [3]. Several risk factors involved in the pathogenesis of AMD have been described, including genetic predisposition, age, and other modifiable factors such as smoking, light and ultraviolet (UV) exposure, dietary factors, and hypertension, which may influence the molecular mechanisms or cellular processes involved in development of the disease
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