Association Of Age-related Macular Degeneration Research Articles

Association between fatty acid intake and age-related macular degeneration: a meta-analysis.

The association of age-related macular degeneration (AMD) with the intake of high and low fatty acids (FAs), respectively, remains controversial. To this end, we performed a comprehensive meta-analysis of all the existing studies on the association of various intake levels of FA subtypes with AMD to determine these associations. A systematic search of PubMed, Web of Science, Cochrane Library, and EMBASE databases was conducted from inception to September 2023. To compare the highest and lowest groups, odds ratio (OR) with 95% confidence intervals (CIs) was analyzed with a random-effects model/fixed-effects model. A high intake of omega-3 LCPUFAs (OR:0.67; 95%CI:[0.51, 0.88]; p = 0.004), DHA (OR:0.80; 95%CI:[0.70, 0.90]; p < 0.001), EPA (OR:0.91; 95%CI:[0.86, 0.97]; p = 0.004), and simultaneous intake of DHA and EPA (OR:0.79; 95%CI:[0.67, 0.93]; p = 0.035) significantly reduced the risk of overall AMD. Conversely, a high intake of trans-FAs (OR: 2.05; 95%CI: [1.29, 3.25]; p = 0.002) was significantly related to an increased risk of advanced AMD compared to the low-intake group. The subgroup analysis results are shown in the articles. Increasing dietary intake of omega-3 LCPUFAs, specifically DHA, and EPA, or the simultaneous intake of DHA and EPA, is significantly associated with a reduced risk of overall AMD. Various subtypes of omega-3 also have a significant association with a reduced risk of different stages of AMD. The high intake of trans-fatty acids (TFAs) is significantly and positively correlated with the risk of advanced AMD. This could further support the idea that consuming foods rich in omega-3 LCPUFAs and reducing consumption of foods rich in TFAs may prevent AMD. https://www.crd.york.ac.uk/prospero/, identifier CRD42023467227.

Unveiling Statins and Genetics in Age-Related Macular Degeneration: The Coimbra Eye Study-Report 9.

To assess the association of age-related macular degeneration (AMD) progression and statins, connected with AMD genetic risk, and if there is an interplay between statins and genetics. In this analysis, 682 subjects made two visits (6.5-year follow-up) of the Coimbra Eye Study. Subjects who started taking statins at any time point between the two visits were considered. Progressors were defined as not having AMD at baseline and having any AMD at follow-up. Genetic risk scores (GRSs) were calculated individually with 52 independent variants associated with AMD. Time to progression was estimated using unadjusted Kaplan-Meier curves. An extended Cox model was used for the association between statins and GRS with the risk for AMD progression. Multiplicative and additive interactions were assessed. Median survival time was 7.50 years for subjects not taking statins and 7.62 for subjects taking statins (P < 0.001). Statin intake reduced the risk for progression to AMD in 48%, adjusting for age, sex, body mass index, smoking, and diabetes (model 1) and GRS (model 2). The combined effects of not taking statins and having high GRS increased the progression risk fourfold compared to taking statins and having low GRS (hazard ratio [HR] = 4.25; 95% confidence interval [CI], 1.62-11.16; P = 0.003). For subjects not taking statins, an increased risk of progression was found for those subjects with high GRS compared to subjects with low GRS (HR = 1.80; 95% CI, 1.13-2.85; P = 0.013). No statistically significant multiplicative or additive interactions were found. Statins seem to be protective against AMD progression, and genetics may play a role in treatment response.

Age-Related Macular Degeneration and Extramacular Drusen: Genetic Associations in the Coimbra Eye Study.

To explore the association between the genetics of age-related macular degeneration (AMD) and extramacular drusen (EMD) in patients with and without AMD. We included 1753 eyes (912 subjects) with phenotypic characterization regarding AMD and EMD. Genetic sequencing and the genetic risk score (GRS) for AMD were performed according to the EYE-RISK consortium methodology. To test for differences in the GRS from EMD cases, AMD cases, and controls, a clustered Wilcoxon rank-sum test was used. The association of AMD, EMD, and the GRS was evaluated using logistic regression models adjusted for age and sex. Individual associations of common risk variants for AMD with EMD were explored. EMD were found in 755 eyes: 252 (14.4%) with AMD and 503 (28.7%) without. In total, 122 eyes (7.0%) had only AMD, and 876 (50.0%) were controls. EMD were strongly associated with AMD (odds ratio [OR], 3.333; 95% confidence interval [CI], 2.356-4.623; P < 0.001). The GRS was associated with an increased risk of AMD (OR, 1.416; 95% CI, 1.218-1.646; P < 0.001) but not with EMD. Individually, the common risk variants ARMS2 rs10490924 (P = 0.042), C3 rs2230199 (P = 0.042), and CETP rs5817082 (P = 0.042) were associated with EMD, after adjustment for AMD, sex, and age. We found a strong association between EMD and AMD, suggesting a common pathogenesis. The GRS for AMD was not associated with EMD, but a partially overlapping genetic basis was suggested when assessing individual risk variants. We propose that EMD per se do not represent an increase in the global genetic risk for AMD.

Association of Age-Related Macular Degeneration with a Blood Biomarker of Lipopolysaccharide, a Gut Bacterial Proinflammatory Toxin.

Chronic inflammation, immune dysregulation, and oxidative stress are major drivers of age-related macular degeneration (AMD) pathogenesis. Lipopolysaccharide (LPS) is a potent proinflammatory toxin originating from gut bacteria. We assessed the association of a blood biomarker of LPS exposure with incident AMD. The Alienor Study is a prospective population-based study, including 963 residents of Bordeaux (France), aged 73years or more at baseline. Esterified 3-hydroxy fatty acids (3-OH FAs) were measured from blood samples as a proxy of LPS burden. AMD was graded from color retinal photographs and spectral domain optical coherence tomography, performed every two years from 2006 to 2017. Cox proportional hazards models were used to estimate associations of between esterified 3-OH FAs, using 722 eyes at risk for incident early AMD and 981 eyes at risk for incident advanced AMD. Higher esterified 3-OH FAs were associated with incident early AMD after adjusting for age and gender (hazard ratio [HR] = 1.21 for 1 standard deviation [SD] increase; 95% confidence interval [CI], 1.01-1.45; P = 0.04) but not with incident advanced AMD (HR = 1.03 for 1 SD increase; 95% CI, 0.73-1.45; P = 0.86). These associations remained stable after multivariate adjustment and imputation for missing covariates (early AMD HR = 1.22 for 1 SD increase; 95% CI, 1.01-1.46; P = 0.04; advanced AMD HR = 0.98 for 1 SD increase; 95% CI, 0.69-1.38; P = 0.91). This study evidenced an association between higher esterified 3-OH FAs and incident early AMD, suggesting that exposure to LPS may be involved in the early pathophysiological processes of AMD.

Impact of Age-Related Macular Degeneration and Related Visual Disability on the Risk of Depression: A Nationwide Cohort Study

To evaluate the prospective association of age-related macular degeneration (AMD) and related visual disability (VD) with the risk of depression. This nationwide population-based cohort study used authorized clinical data provided by the Korean National Health Insurance Service. A total of 3,599,589 individuals over 50 years of age participated in the Korean National Health Screening Program in 2009. AMD diagnosis and the presence of accompanying VD were verified using diagnostic codes and disability registration data. Data on covariates, including age, sex, income level, residential area, systemic comorbidities, and behavioral factors, were collected from health screening results and claims data. Patients were followed until December 2019, and incident cases of depression were identified using registered diagnostic codes. The prospective association of AMD and related VD with new-onset depression was investigated using the multivariable-adjusted Cox proportional hazard model. Hazard ratios and 95% confidence intervals for depression development according to the presence of AMD and VD. During an average follow-up period of 8.52 years, 1,037,088 patients were newly diagnosed with depression. Patients previously diagnosed with AMD had a greater risk of new-onset depression, with a hazard ratio (95% confidence interval) of 1.15 (1.13-1.17), compared to the control group in the fully adjusted model. Patients with AMD and accompanying VD had a further increased risk of depression, with a hazard ratio (95% confidence interval) of 1.23 (1.16-1.30). Individuals diagnosed with AMD have a higher risk of developing depression in the future. The risk of depression is further increased in AMD patients with VD.

Association of age‐related macular degeneration on Alzheimer or Parkinson disease

AbstractPurpose: To determine the association of age‐related macular degeneration (AMD) with Alzheimer disease (AD) and Parkinson disease (PD).Methods: The study population consisted of 308 340 participants aged 50 years or older from the Korean National Health Insurance Service‐Health Screening Cohort. After exclusion of participants with AMD during 2002, participants were detected for AMD during 2003–2005. Starting from January 1, 2006, all participants were followed up for AD and PD until December 31, 2013. Multivariate Cox proportional hazards regression was used to calculate the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for AD and PD risk.Results: Compared to non‐AMD participants, AMD patients had higher risk for AD (aHR 1.48, 95% CI 1.25–1.74) and PD (aHR 1.46, 95% CI 1.14–1.88). The risk‐increasing association of AMD with AD (aHR 2.25, 95% CI 1.39–3.66) and PD (aHR 2.02, 95% CI 1.00–4.08) were preserved among participants who were never‐smokers, did not consume alcohol, and exercised regularly. Finally, AMD was associated with higher risk of AD (aHR 1.96, 95% CI 1.46–2.65 for age &lt; 70 years and aHR 1.53, 95% CI 1.26–1.86 for age ≥ 70 years) and PD (aHR 1.90, 95% CI 1.29–2.80 for age &lt; 70 years and aHR 1.47, 95% CI 1.06–2.04 for age ≥ 70 years) according to subgroups divided by age.Conclusions: Compared to non‐AMD participants, AMD patients had higher risk for AD and PD even among those with healthy lifestyle behaviours. Patients with AMD must be closely monitored for possible subsequent development of AD or PD.

Association of Age-Related Macular Degeneration with Prior Hyperthyroidism and Hypothyroidism: A Case-Control Study.

Prior studies suggest a possible association between thyroid disease and the subsequent development of age-related macular degeneration (AMD), although it remains inconclusive. This study aimed to evaluate the association of AMD with prior hyper-/hypothyroidism based on nationwide population-based data. We retrieved records of the study patients from the National Health Insurance Research Database, 7522 patients with a first-time diagnosis of AMD and 7522 propensity score-matched controls. Multiple logistic regression analyses were performed to explore the association of neovascular AMD with previously diagnosed hyperthyroidism or hypothyroidism. The Chi-square test shows that there was a statistically significant difference in the prevalence of prior hyperthyroidism between cases and controls (1.18 vs. 0.13%, p < 0.001). Furthermore, there was a statistically significant difference the prevalence of prior hypothyroidism between cases and controls (0.44 vs. 0.69%, p < 0.001). Multiple logistic regression analysis reveals that AMD was statistically and significantly associated with prior hyperthyroidism after adjusting for age, sex, monthly income, geographical location, urbanization level, hypertension, hyperlipidemia, diabetes, and coronary heart disease (odds ratio (OR) = 9.074, 95% CI = 4.713–17.471). The adjusted OR of prior hypothyroidism in patients with AMD was 3.794 (95% CI: 2.099~6.858) when compared to the controls. We conclude that patients with thyroid dysfunction are at higher risk of developing AMD Results suggest that these patients could benefit from proactive regular eye checkups to detect evolving eye pathology, even while vision remains normal during the initial phases.

Association of age-related macular degeneration on fracture risks among osteoporosis population: a nationwide population-based cohort study

ObjectivesVisual impairment is an important risk factor for fracture in the elderly population. Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment in elderly people. This study...

Association of Age-Related Macular Degeneration with Cardiovascular Diseases in Korean Adults: 2017 Korea National Health and Nutrition Examination Surveys

Purpose : This study was to investigate the risk factors of age-related macular degeneration according to cardiovascular diseases in Korean adults over 40 years of age. Methods : National Health and Nutrition Survey the 7th 2017 survey of Health Surveys and ophthalmology examination for subjects age-related macular degeneration related cardiovascular diseases, sex, age, body mass index, and sociological factors logistic regression analysis was performed by correcting household income, education, current smoking rate, and monthly drinking rate, and the significance level was less than 0.050. Results : The prevalence of age-related macular degeneration over the age of 40 was 7.23% for men and 7.94% for women. For age-related macular degeneration, age(OR=1.050, p＜0.001), sex(OR=0.693, p=0.024), stroke(OR=0.353, p=0.004), and myocardial infarction(OR=2.033, p=0.032) was significant. BMI(OR=1.008, p=0.626), household income(OR=1.000, p=0.296), education level (OR=0.927, p=0.181), smoking rate(OR=0.873, p=0.397), drinking rate(OR=0.922, p=0.489), hypertension( OR=0.981, p=0.872), and angina pectoris(OR=0.732, p=0.357) were not significant. Conclusion : After correcting sociological factors in the relationship between age-related macular degeneration and cardiovascular diseases, statistically significant relationships were identified with age, sex, stroke, and myocardial infarction.

Genetic Association of Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy.

Age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) are leading causes of irreversible blindness among the elderly population in developed countries. Although being considered as different subtypes of a same disease, neovascular AMD and PCV have differences in clinical, epidemiological, therapeutic, and genetic profiles. Both AMD and PCV are complex diseases involving multiple genetic and environmental risk factors. Different genetic strategies have been adopted to discover associated genes and variants for neovascular AMD and PCV, including genome-wide association study (GWAS), next-generation sequencing (NGS) based sequence analysis, and candidate gene analyses. So far, a number of susceptible genes have been identified for AMD and/or PCV, such as CFH, ARMS2-HTRA1, C2-CFB-SKIV2L, C3, CETP, and FGD6. Although many of these genes are shared by AMD and PCV, some showed difference between them, such as ARMS2-HTRA1 and FGD6. Also, some of the genes showed ethnic diversities, such as the CFH p.Tyr402His variant. Further larger-scale genomic studies should be warranted to identify more susceptibility genes for AMD and, in particular, PCV among different populations, and differentiate the genetic architectures between neovascular AMD and PCV.

Evaluation of Modifiable Risk Factors in the Development of Age Related Macular Degeneration in Kashmiri Population

Age Related Macular Degeneration (ARMD) is the leading cause of irreversible visual loss, adversely affecting the quality of life. It is a degenerative disorder of the macula involving the choriocapillaries, Bruchs membrane, retinal pigment epithelium and the photoreceptors. It is a multifactorial disease occurring due to a complex interplay of genetic and environmental factors. Gender, ethnicity, smoking, obesity, hypertension, diabetes, history of cardiovascular disorders, high fat intake, low intake of carotenoids, history of cataract surgery, blue iris colour, high sunlight exposure are some of the risk factors, many of which are very well documented and some still remain controversial due to lack of evidence.&#x0D; Objective&#x0D; The aim of our study was to evaluate the role of some of the modifiable non genetic risk factors in the causation of ARMD and the role of healthy lifestyle in preventing the visual loss due to ARMD.&#x0D; Materials &amp; Method&#x0D; This is a case control study which was conducted on the outdoor patients attending Al Kabir eye care center, Srinagar. The ARMD status of the patients was confirmed by thorough ophthalmological examination by a single opthalmologist. Height, weight BMI, history of smoking, history of hypertension, hyperopia, and cataract surgery was taken. Iris color was noted. Detailed dietary history regarding intake of fruits, vegetables, beef, lamb, and fish was taken. Data was analysed using Chi square test.&#x0D; Result&#x0D; We found that prevalence of ARMD increases after 60 years of age. History of smoking, history of higher intake of beef and lamb is strongly associated with ARMD (p value &lt;0.01and &lt;0.03 respectively). We did not find any association between ARMD and history of cataract surgery, hyperopia or hypertension nor did our study find any significant difference in the association of ARMD and iris colour.&#x0D; Conclusion&#x0D; From our analysis we can conclude that ARMD is a disease of the older population and cigarette smoking, excessive consumption of beef and lamb are significant risk factors for the causation of ARMD

Association of Age-Related Macular Degeneration on Alzheimer or Parkinson Disease: A Retrospective Cohort Study

To determine the association of age-related macular degeneration (AMD) with Alzheimer disease (AD) and Parkinson disease (PD). Retrospective cohort study. The study population consisted of 308,340 participants aged 50 years or older from the Korean National Health Insurance Service-Health Screening Cohort. After exclusion of participants with AMD during 2002, participants were detected for AMD during 2003-2005. Starting from January 1, 2006, all participants were followed up for AD and PD until December 31, 2013. Multivariate Cox proportional hazards regression was used to calculate the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for AD and PD risk. Compared to non-AMD participants, AMD patients had higher risk for AD (aHR 1.48, 95% CI 1.25-1.74) and PD (aHR 1.46, 95% CI 1.14-1.88). The risk-increasing association of AMD with AD (aHR 2.25, 95% CI 1.39-3.66) and PD (aHR 2.02, 95% CI 1.00-4.08) were preserved among participants who were never-smokers, did not consume alcohol, and exercised regularly. Finally, AMD was associated with higher risk of AD (aHR 1.96, 95% CI 1.46-2.65 for age <70 years and aHR 1.53, 95% CI 1.26-1.86 for age ≥70 years) and PD (aHR 1.90, 95% CI 1.29-2.80 for age <70 years and aHR 1.47, 95% CI 1.06-2.04 for age ≥70 years) according to subgroups divided by age. Compared to non-AMD participants, AMD patients had higher risk for AD and PD even among those with healthy lifestyle behaviors. Patients with AMD must be closely monitored for possible subsequent development of AD or PD.

Comorbidity of dementia and age-related macular degeneration calls for clinical awareness: a meta-analysis

AimTo determine the association between dementia and age-related macular degeneration (AMD) using meta-analysis.MethodsWe searched in the MEDLINE, EMBASE, Web of Knowledge, PsycInfo and Cochrane database of systematic reviews for studies...

A study of occurrence and risk factors of age-related macular degeneration in a region of Central India

Purpose: The purpose of the study is to determine the occurrence of age-related macular degeneration (AMD) in patients aged >50 years and to study risk factors associated with it. Materials and Methods: It was a cross-sectional prospective study, in which 907 patients aged 50 years and above of both sexes were studied who visited eye outpatient department of our tertiary hospital between October 2014 and September 2016. Visual acuity, slit-lamp examination, and disc and macular evaluation with 90D lens and 20D using indirect ophthalmoscope were performed. AMD was confirmed by doing fundus fluorescein angiography. Association of AMD with hypertension, diabetes, cardiovascular disease, smoking, alcohol consumption, and body mass index were studied. Results: Out of 907 patients, 21 had AMD, i.e., the occurrence was 2.3%. Of 21 patients, 15 had early AMD (1.6%) and 6 had late AMD (0.7%). The highest occurrence of 9.75% was seen in age group of 80 years and above, whereas other risk factors of AMD, i.e., smoking showed P = 0.1261, cardiovascular disease P = 0.0251, and prior cataract surgery with P = 0.0001. Conclusion: Age was found to be strong and consistent risk factor of AMD. Smoking, cardiovascular disease, and prior cataract surgery were significantly associated with AMD.

Association of Age-Related Macular Degeneration With Risk of All-Cause and Specific-Cause Mortality in the National Health and Nutrition Examination Survey, 2005 to 2008

Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment and blindness in the United States if subretinal neovascularization is left untreated. Knowledge of the association between AMD and survival is informative for underlying mechanisms of AMD. To examine the association between AMD and risk of all-cause and specific-cause mortality in a representative US sample. This population-based prospective cohort study included 5603 participants 40 years or older who responded to the National Health and Nutrition Examination Survey (NHANES) in the 2005-2008 phase. Retinal photographs were graded as early, late, or no AMD. All analyses accounted for the complex and stratified design of NHANES with weighted data. Risks of all-cause mortality were assessed with Cox proportional hazards regression models; risks of specific-cause mortality, with Fine and Gray competing risks regression models. Time to death was counted from baseline to date of death or December 31, 2011, whichever came first. Data analysis was conducted from April 1 through 30, 2018. Age-related macular degeneration status as determined by digital fundus images. Mortality resulting from all causes and specific causes until December 31, 2011. Among the 5603 participants (52.6% female [n = 2793] and 77.1% white [n = 3017]; mean [SE] age, 56.4 [0.4] years), weighted prevalence of any AMD was 6.6%, with 386 (5.8%) having early AMD and 55 (0.8%) having late AMD. After a median follow-up of 4.5 years (interquartile range, 3.6-5.6 years), 433 (5.3%) died of all causes, of whom 361 (83.1%) had no AMD, 54 (11.5%) had signs of early AMD, 18 (5.4%) had signs of late AMD, and 72 (16.9%) had any AMD at baseline. Overall, unadjusted all-cause and specific-cause mortality rates were higher for those participants who had early, late, or any AMD compared with no AMD. However, after adjusting confounding factors, only late AMD was associated with more than a doubling of all-cause mortality (hazard ratio [HR], 2.01; 95% CI, 1.00-4.03) and more than a 3-fold higher risk of mortality due to causes other than cardiovascular disease and cancer (HR, 3.42; 95% CI, 1.38-8.49). No association was identified between AMD presence or early AMD and all-cause or specific-cause mortality. In this study's findings, only late AMD was independently associated with all-cause mortality and mortality due to causes other than cardiovascular disease and cancer, indicating that late AMD may be a marker of biological aging. Alternatively, this association may be due to unmeasured or inadequately assessed confounding factors for late AMD.

Association of Age-related Macular Degeneration With Mortality in Patients With Acquired Immunodeficiency Syndrome; Role of Systemic Inflammation

To evaluate the relationships among age-related macular degeneration (AMD), mortality, and biomarkers of systemic inflammation in patients with acquired immunodeficiency syndrome (AIDS). Case-control study. In participants with intermediate-stage AMD at enrollment in the Longitudinal Study of the Ocular Complications of AIDS (LSOCA) and 2:1 controls matched for age and sex, cryopreserved baseline plasma specimens were assayed for biomarkers of inflammation, including high-sensitivity C-reactive protein (CRP), interleukin (IL)-6, interferon-γ inducible protein (IP)-10, soluble CD14 (sCD14), soluble CD163 (sCD163), kynurenine/tryptophan (KT) ratio, and intestinal fatty acid binding protein (I-FABP). Main outcome measure was mortality. The study included 189 patients with AMD and 385 controls. In the unadjusted analysis, AMD was associated with mortality (hazard ratio [HR] 1.48; 95% confidence interval [CI] 1.02, 2.15; P= .04). In an adjusted analysis, CRP (HR 1.36; 95% CI 1.08, 1.71; P= .009), IL-6 (HR 1.45; 95% CI 1.11, 1.90; P=.006), and IP-10 (HR 1.41; 95% CI 1.08, 1.84; P= .01) were associated with mortality. In a Cox regression analysis adjusted for human immunodeficiency virus load, blood CD4+ Tcell level, CRP, IL-6, and IP-10, the association of AMD with mortality was attenuated (HR 1.08; 95% CI 0.73, 1.59; P= .70), primarily by the addition of the inflammatory biomarkers. These data suggest that the increased mortality observed in patients with AIDS with AMD is, at least in part, a result of systemic inflammation.

Risk Factors for Age-Related Macular Degeneration in Korean : based on National Health and Nutrition Examination Survey Analysis in 2011 and 2012

Purpose : We investigated correlation between dietary supplements such as vitamins and minerals, and progression of age-related macular degeneration (AMD) in Korean based on the National Health and Nutrition Examination Survey in 2011 and 2012. Methods : We analyzed the correlation between AMD and vitamin, mineral intakes for adults aged 45 years and older. They underwent physical examinations and eye examinations during the period of the National Health and Nutrition Survey. The association of AMD and vitamin, mineral intakes were analysed using cross-tabulation, and Chi-square test and also the risk ratio (odds ratio) using logistic regression. The significance level was p<0.05. Results : Of 6,219 Koreans over the age of 45 who were participated in the National Health Nutrition Examination, the rate of AMD was 9.6 %. The early AMD was associated with nutrient vitamin A, B1, B2, B3, C and calcium, phosphorus, iron, sodium and potassium intakes. The risk of early AMD was 1.35 times higher (95 % confidence interval : 1.03 to 1.78) in the group of the intake of vitamin B3 was below the average. In the late AMD, the prevalence rate was higher when the intake of potassium and vitamin B2 were lower than the average, and the risk of late AMD was 4.3 times (95 % confidence interval : 1.76) higher when the intake of potassium was below the average. Conclusions : The intake of vitamin and mineral was associated with a reduction of the risk of AMD progression and also prevention of AMD.

Association of obesity and age-related macular degeneration in Indian population.

Purpose:The aim of this study was to establish the prevalence and association of age-related macular degeneration (AMD) and obesity which was not studied extensively in Indian population over 60 years of age.Methods:This was a cross-sectional, population-based study. A total of 4791 patients with gradable fundus photography were included. All patients underwent detailed ophthalmic examination and AMD was graded with retinal photographs. Grading of AMD was done according to the International ARM Epidemiological Study Group and staged based on grading in worse eye. The association of AMD severity and obesity (based on body mass index, waist–hip ratio, waist circumference, isolated abdominal obesity, isolated generalized obesity, and combined obesity) was assessed. The main outcome variable was an association between the presence and severity of AMD with different grades of obesity.Results:No direct significant association was noted between the presence and severity of AMD and any obesity indices. Subgroup analyses based on lifestyle patterns and common systemic pathologies in AMD population were done. Late AMD was significantly associated with tobacco consumption in population with combined obesity (P = 0.033 and odds ratio = 2.998).Conclusion:No direct association was noted between the presence or severity of AMD and obesity in South Indian population. However, indirect associations between the severity of AMD and combined obesity were found.

Prevalence of Undiagnosed Age-Related Macular Degeneration in Primary Eye Care

Age-related macular degeneration (AMD) is the leading cause of irreversible vision impairment in older adults in the United States, yet little is known about whether AMD is appropriately diagnosed in primary eye care. To examine the prevalence of eyes with AMD in patients seen in primary eye care clinics who purportedly have normal macular health per their medical record and the association of AMD with patient and physician characteristics. In this cross-sectional study of primary eye care practices in Birmingham, Alabama, 644 persons 60 years or older with normal macular health per medical record based on their most recent dilated comprehensive eye examination by a primary eye care ophthalmologist or optometrist were enrolled from May 1, 2009, through December 31, 2011. Data analysis was performed from May 1, 2016, through December 20, 2016. Presence of AMD as defined by the Clinical Age-Related Maculopathy Staging system based on color fundus photography and a masked grader. Types of AMD-associated lesions were noted. Patient health and physician characteristics were collected. The sample consisted of 1288 eyes from 644 participants (231 [35.9%] male and 413 [64.1%] female; mean [SD] age, 69.4 [6.1] years; 611 white [94.9%]) seen by 31 primary eye care ophthalmologists or optometrists. A total of 968 eyes (75.2%) had no AMD, in agreement with their medical record; 320 (24.8%) had AMD despite no diagnosis of AMD in the medical record. Among eyes with undiagnosed AMD, 32 (10.0%) had hyperpigmentation, 43 (13.4%) had hypopigmentation, 249 (77.8%) had small drusen, 250 (78.1%) had intermediate drusen, and 96 (30.0%) had large drusen. Undiagnosed AMD was associated with older patient age (odds ratio [OR], 1.06; 95% CI, 1.04-1.09; P < .001), male sex (age-adjusted OR, 1.39; 95% CI, 1.02-1.91; P = .04), and less than a high school education (age-adjusted OR, 2.40; 95% CI, 1.03-5.62; P = .04). Prevalence of undiagnosed AMD was not different for ophthalmologists and optometrists (age adjusted OR, 0.99; 95% CI, 0.71-1.36; P = .94). Approximately 25.0% of eyes deemed to be normal based on dilated eye examination by primary eye care physicians had macular characteristics that indicated AMD revealed by fundus photography and trained raters. A total of 30.0% of eyes with undiagnosed AMD had AMD with large drusen that would have been treatable with nutritional supplements had it been diagnosed. Improved AMD detection strategies may be needed in primary eye care as more effective treatment strategies for early AMD become available in the coming years.

The Association between Age-Related Macular Degeneration and the Risk of Mortality.

Studies have investigated the association between age-related macular degeneration (AMD) and subsequent risks of mortality, but results have been equivocal. We conducted a comprehensive analysis of prospective cohort studies to assess the association of AMD and the risk of mortality in the general population. We searched PubMed and EMBASE for trials published from 1980 to 2016. We included 11 cohort studies that reported relative risks with 95% confidence intervals for the association of AMD and mortality, involving 57,069 participants. In a random-effects model, the adjusted RR (95% confidence interval) associated with AMD was 1.09 (1.02–1.17) for all-cause mortality. Findings from this research provide support that persons with AMD had a higher subsequent risk of mortality than persons without AMD.