Population-based retrospective cohort study on risk of age-related macular degeneration in people with chronic obstructive pulmonary disease

Pei-Jane Bair,Te-Chun Shen,Chi‐Yuan Li,Ning-Yi Hsia,Cheng-Li Lin,Yu-Cih Yang

doi:10.1038/s41598-021-94657-9

Abstract

Chronic obstructive pulmonary disease (COPD) and age-related macular degeneration (AMD) are both common diseases of the elderly people. COPD induced systemic inflammation and hypoxia may have an impact on the development of AMD. This study investigated the possible association between COPD and subsequent risk of AMD. A retrospective cohort study was conducted based on the data from the National Health Insurance Research Database in Taiwan. The COPD cohort comprised 24,625 adult patients newly diagnosed during 2000–2012, whereas age-, gender-, and the year of diagnosis-matched non-COPD cohort comprised 49,250 individuals. Incident AMD was monitored to the end of 2013. A Cox proportional hazards model was applied to evaluate the risk of AMD. The COPD cohort showed 1.25 times higher AMD incidence than the non-COPD cohort (4.80 versus 3.83 per 1000 person-years, adjusted hazard ratio (HR) = 1.20 [95% confident interval (CI) = 1.10–1.32]). Stratified analyses for age, gender, and presence of comorbidity resulted in significant adjusted HRs in most subgroups. Further analysis revealed that the COPD group had an increased risk of both the exudative and non-exudative types of AMD (adjusted HRs = 1.49 [95% CI = 1.13–1.96] and 1.15 [95% CI = 1.05–1.26], respectively). COPD patients have an increased risk for AMD development. Clinicians should provide adequate care for the ocular health to these patients.

Highlights

Chronic obstructive pulmonary disease (COPD) and age-related macular degeneration (AMD) are both common diseases of the elderly people
The overall AMD incidence rate was higher in the COPD group than in the non-COPD group (4.80 vs. 3.83 per 1000 person-years) (Table 2)
The corresponding adjusted HRs (aHRs) in the COPD group compared with the non-COPD group, adjusted for age and comorbidities, was 1.20

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) and age-related macular degeneration (AMD) are both common diseases of the elderly people. This study investigated the possible association between COPD and subsequent risk of AMD. Klein et al conducted a populationbased cohort study and reported that a history of emphysema at baseline was associated with a 5.12-fold risk for exudative AMD occurrence[17]. The authors extended the study and reported that a history of emphysema at baseline was associated with a 3.65-fold risk for the 15-year exudative AMD cumulative incidence[18]. Zlateva et al conducted a case–control study to investigate comorbid conditions in individuals with and without neovascular AMD20

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