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Cardiovascular disease and hypertension are strong risk factors for choroidal neovascularization.

Abstract：

PURPOSE:To investigate the association of cardiovascular risk factors and inflammatory markers with neovascular age-related macular degeneration (AMD). DESIGN:Cross-sectional case-control study. PARTICIPANTS:Of the 410 of the >/=65-year-old community sample invited to attend, 205 participated (50% response rate). Of the 215 clinic attendees who were invited to participate, 212 agreed to take part (98% response rate). A diagnosis of neovascular AMD in at least one eye was made in 193 clinic attendees and 2 of the community sample. METHODS:Clinic and community participants underwent a detailed ophthalmic examination with fundus imaging, were interviewed for assessment of putative risk factors, and provided a blood sample. Analysis included levels of serum lipids, intercellular adhesion molecule 1 (ICAM), vascular cellular adhesion molecule (VCAM), and C-reactive protein (CRP). All participants were classified by fundus image grading on the basis of the eye with more severe AMD features. MAIN OUTCOME MEASURE:Neovascular AMD. RESULTS:There were 195 participants with choroidal neovascularization in at least one eye, 97 nonneovascular AMD participants, and 115 controls (no drusen or pigmentary irregularities in either eye). In confounder-adjusted logistic regression, a history of cardiovascular disease was strongly associated with neovascular AMD (odds ratio [OR], 7.53; 95% confidence interval [CI], 2.78-20.41). Cigarette smoking (OR, 3.71; 95% CI, 1.25-11.06), being in the highest quartile of body mass index (OR, 3.82; 95% CI, 1.22-12.01), stage 2 hypertension (OR, 3.21; 95% CI, 1.14-8.98), and being in the highest quartile of serum cholesterol (OR, 4.66; 95% CI, 1.35-16.13) were positively associated with neovascular AMD. There was no association between AMD status and serum CRP, ICAM, or VCAM. CONCLUSIONS:Our results suggest that cardiovascular disease plays an etiological role in the development of choroidal neovascularization in a proportion of older adults and highlight the importance of control of blood pressure and cholesterol, avoidance of smoking, and maintenance of a normal body weight.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Hogg RE,Woodside JV,Gilchrist SE,Graydon R,Fletcher AE,Chan W,Knox A,Cartmill B,Chakravarthy U

doi

10.1016/j.ophtha.2007.07.031

subject

Has Abstract

pub_date

2008-06-01 00:00:00

pages

1046-1052.e2

issue

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(07)00847-0

journal_volume

115

pub_type

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Cardiovascular disease and hypertension are strong risk factors for choroidal neovascularization.