Abstract
Age-related macular degeneration (AMD) is a major cause of severe vision loss in elderly people. Diabetes mellitus is a common endocrine disorder with serious consequences, and diabetic retinopathy (DR) is the main ophthalmic complication. DR and AMD are different diseases and we seek to explore the relationship between diabetes and AMD. MEDLINE, EMBASE, and the Cochrane Library were searched for potentially eligible studies. Studies based on longitudinal cohort, cross-sectional, and case-control associations, reporting evaluation data of diabetes as an independent factor for AMD were included. Reports of relative risks (RRs), hazard ratios (HRs), odds ratio (ORs), or evaluation data of diabetes as an independent factor for AMD were included. Review Manager and STATA were used for the meta-analysis. Twenty four articles involving 27 study populations were included for meta-analysis. In 7 cohort studies, diabetes was shown to be a risk factor for AMD (OR, 1.05; 95% CI, 1.00–1.14). Results of 9 cross-sectional studies revealed consistent association of diabetes with AMD (OR, 1.21; 95% CI, 1.00–1.45), especially for late AMD (OR, 1.48; 95% CI, 1.44–1.51). Similar association was also detected for AMD (OR, 1.29; 95% CI, 1.13–1.49) and late AMD (OR, 1.16; 95% CI, 1.11–1.21) in 11 case-control studies. The pooled ORs for risk of neovascular AMD (nAMD) were 1.10 (95% CI, 0.96–1.26), 1.48 (95% CI, 1.44–1.51), and 1.15 (95% CI, 1.11–1.21) from cohort, cross-sectional and case-control studies, respectively. No obvious divergence existed among different ethnic groups. Therefore, we find diabetes a risk factor for AMD, stronger for late AMD than earlier stages. However, most of the included studies only adjusted for age and sex; we thus cannot rule out confounding as a potential explanation for the association. More well-designed prospective cohort studies are still warranted to further examine the association.
Highlights
Age-related macular degeneration (AMD) has become a major cause of irreversible visual impairments in elderly people around the world, casting a heavy socio-economic burden on eye care [1,2,3]
The odds ratio (OR)/relative risk (RR)/hazard ratio (HR) with 95% confidence interval (CI) and the corresponding adjusted variables for each study were listed in overall AMD, early AMD or late AMD (Table 2)
We found that diabetes is a risk factor for AMD, especially for neovascular AMD (nAMD)
Summary
Age-related macular degeneration (AMD) has become a major cause of irreversible visual impairments in elderly people around the world, casting a heavy socio-economic burden on eye care [1,2,3]. AMD can be classified into the early and late stages. Patients with early AMD are usually asymptomatic, while severe vision loss frequently occurs in its late stage. Late AMD can be further categorized into two main subtypes: neovascular AMD (nAMD) and geographic atrophy (GA) [3]. The estimated prevalence is 6.8% for early AMD and 1.5% for late AMD in Caucasians over the age of 40 years [3]. It is estimated that 5% of early AMD patients will progress to late AMD over a 5-year period, increasing to nearly 15% over a 15-year period [4,5]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
