Association of age-related macular degeneration with age-related hearing loss

Short-Term Clinical Results of Preferred Retinal Locus Training

Objectives

This study evaluated acoustic biofeedback training using microperimetry in patients with foveal scars and an eligible retinal locus for better fixation.

Materials and Methods

A total of 29 eligible patients were enrolled in the study. The acoustic biofeedback training module in the MAIA (Macular Integrity Assessment, CenterVue®, Italy) microperimeter was used for training. To determine the treatment efficacy, the following variables were compared before and after testing: best corrected visual acuity (BCVA); MAIA microperimeter full threshold 4-2 test parameters of average threshold value, fixation parameters P1 and P2, and bivariate contour ellipse area (BCEA) for 63% and 95% of fixation points; contrast sensitivity (CSV 1000E Contrast Sensitivity Test); reading speed using the Minnesota Low-Vision Reading Test (MNREAD reading chart); and quality of life (NEI-VFQ-25). In addition, fixation stability parameters were recorded during each session.

Results

The study group consisted of 29 patients with a mean age of 68.72±8.34 years. Median BCVA was initially 0.8 (0.2-1.6) logMAR and was 0.8 (0.1-1.6) logMAR after 8 weeks of preferred retinal locus training (p=0.003). The fixation stability parameter P1 improved from a mean of 21.28±3.08% to 32.69±3.69% (p=0.001) while mean P2 improved from 52.79±4.53% to 68.31±3.89% (p=0.001). Mean BCEA 63% decreased from 16.11±2.27^°2 to 13.34±2.26^°2 (p=0.127) and mean BCEA 95% decreased from 45.87±6.72^°2 to 40.01±6.78^°2 (p=0.247) after training. Binocular reading speed was 38.28±6.25 words per minute (wpm) before training and 45.34±7.35 wpm after training (p<0.001). Statistically significant improvement was observed in contrast sensitivity and quality of life questionnaire scores after training.

Conclusion

Beginning with the fifth session, biofeedback training for a new trained retinal locus improved average sensitivity, fixation stability, reading speed, contrast sensitivity, and quality of life in patients with macular scarring.

Dual Sensory Impairment: The Correlation between Age Related Macular Degeneration and Sensorineural Hearing Loss

The pathogeneses of age-related macular degeneration (AMD) and age-related hearing impairment are not yet fully understood. If AMD and age-related hearing impairment are correlated, the cause of both may be a result of a common vulnerability. The aim of this study was to assess the interrelation between age-related macular degeneration and age-related hearing loss. Material and methods: In our case-control analysis, the hearing conditions of 40 subjects with AMD were compared with 40 age-matched healthy controls. In all patients, retinal changes were certified by clinical examinations, optical coherence tomography (OCT), and fluorescein angiography (FA). All subjects were inspected with pure tone audiometry (PTA), impedance audiometry, and speech audiometry. Results: A significant correlation (p < 0.001) was identified between age-related macular degeneration and age-related hearing impairment. The predominant hearing impairment in this case was sensorineural (SNHL). Of the patients diagnosed with AMD, SNHL was found in 88.89% of those with exudative macular degeneration and in 67.74% of those with atrophic macular degeneration. In contrast, we found that a significant proportion of the control group had normal hearing. Conclusion: One possible explanation for the association between retinal and cochlear impairment may be due to a melanin disorder.

Effects of cigarette smoking on sensorineural hearing impairment and age related macular degeneration

INTRODUCTION

Cigarette smoking has been causally associated with various diseases, and among the numerous harmful effects of smoking is included its impact on the senses of vision and hearing. The purpose of this study is to evaluate the impact of cigarette smoking on the visual and auditory functions.

METHODS

In this analytic study, hearing and smoking status of 40 patients with agerelated macular degeneration (AMD) were analyzed with 40 age-matched control subjects without AMD. In all subjects (n=80), retinal status was investigated by optical coherence tomography (OCT), with analyses of thickness central subfield (TCS) and thickness average cube (TAC) of the macula. All participants were examined with pure tone audiometry. Audiometric trials comprised pure tone bone and air conduction. The smoking history of all the subjects was recorded in detail.

RESULTS

A significant correlation was found between smoking status and visual (p<0.001) and hearing impairment (p<0.05). Cigarette smoking was found to be highly correlated with sensorineural hearing impairment and exudative macular degeneration.

CONCLUSIONS

Cigarette smoking damage anti-oxidative systems and tissue metabolism. We have underlined a clear correlation between the risk of sensorineural hearing impairment, exudative macular degeneration and cigarette smoking. Our findings may result in future screening of smokers to identify any hearing and vision impairment and for improving smoking cessation interventions.

Prevalence and Associated Factors of Age-Related Macular Degeneration in a Russian Population: The Ural Eye and Medical Study

PURPOSE

To assess the prevalence of age-related macular degeneration (AMD) in a Russian population.

DESIGN

Population-based prevalence assessment.

METHODS

The Ural Eye and Medical Study was conducted in a rural and urban area in the Russian republic of Bashkortostan. The study included 5,899 participants aged 40+ years old. AMD, defined according to the Beckman Initiative for Macular Research, was assessed by fundus photographs and optical coherence tomographic images of 4,932 (83.6%) participants.

RESULTS

The prevalence of any AMD, early AMD, intermediate AMD, or late AMD, geographic atrophy, and neovascular AMD were 18.2% (95% confidence interval [CI], 16.8-19.6), 11.6% (95% CI, 10.4-12.8), 5.0% (95% CI, 4.2-5.8), 1.6% (95% CI, 1.1-2.0), 0.7% (95% CI, 0.4-1.0) and 0.9% (95% CI, 0.6-1.3), respectively, for individuals >55 years old. Applying an age limit of 40+ years for the AMD definition, prevalence of any AMD, early AMD, intermediate AMD, late AMD, geographic atrophy and neovascular AMD were 14.1% (95% CI, 13.1-15.1), 9.4% (95% CI, 8.6-10.2), 3.8% (95% CI, 3.2-4.3), 1.0% (95% CI, 0.7-1.2), 0.4% (95% CI, 0.2-0.6) and 0.5% (95% CI, 0.3-0.7), respectively, for individuals aged 40+ years. Higher AMD prevalence was correlated with older age (odds ratio [OR], 1.15; 95% CI, 1.13-1.16; P < 0.001), rural region (OR, 1.69; 95% CI, 1.32-2.17; P < 0.001), lower diabetes prevalence (OR, 0.56; 95% CI, 0.38-0.82; P = 0.003), and shorter axial length (OR, 0.89; 95% CI, 0.79-0.99; P = 0.04). AMD prevalence was not significantly (all P ≥ 0.20) correlated with any systemic parameter examined, except for lower prevalence of diabetes.

CONCLUSIONS

In this typical, ethnically mixed, urban and rural population from Russia, a higher prevalence for AMD was associated mainly with older age, rural region of habitation, shorter axial length, and lower prevalence of diabetes mellitus. The AMD prevalence was lower than in Europeans and higher than in East Asians.

Increased incidence of age-related macular degeneration in sensorineural hearing loss: A population-based cohort study

Background

To evaluate the incidence of age-related macular degeneration (AMD) in patients diagnosed with sensorineural hearing loss (SNHL) via the application of the National Health Insurance Research Database in Taiwan.

Methodology/Principal findings

A retrospective cohort study was conducted. Patients with a diagnosis of SNHL was enrolled in the study group after exclusion and a propensity score matched group without SNHL was served as the control group with a 1:2 ratio. The main outcome was regarded as the emergence of AMD diagnostic codes. Cox proportional hazard regression was applied to analyze the incidence and adjusted hazard ratio (aHR) of AMD in the multivariate model. A total of 15,686 patients with SNHL were included in the study group while another 31,372 non-SNHL patients served as the control group. After a follow-up interval up to 16 years, there were 484 AMD events occurred in the study group and 660 AMD cases in those non-SNHL patients with a significantly higher aHR compared to the control group after adjusting for multiple potential risk factors (aHR: 1.399, 95% CI: 1.244–1.574). Other prominent risk factors for AMD included older age, ischemic heart disease, hyperlipidemia, Alzheimer's disease, liver disease and kidney disease. Besides, a higher cumulative probability of AMD was observed in the study group (log-rank P <0.0001).

Conclusion

The patients with SNHL demonstrated a higher incidence of developing AMD.

Increased Incidence of Glaucoma in Sensorineural Hearing Loss: A Population-Based Cohort Study

The purpose of the current study was to evaluate the incidence of glaucoma in patients diagnosed with sensorineural hearing loss (SNHL) via the application of the National Health Insurance Research Database in Taiwan. A retrospective cohort study was conducted. Patients with a diagnosis of SNHL were enrolled in the study group after an exclusion procedure and a propensity score matched group without SNHL was served as the control group with a 1:2 ratio. The main outcome was regarded as the emergence of glaucoma diagnostic codes. Cox proportional hazard regression was applied to analyze the incidence and adjusted hazard ratio (aHR) of glaucoma in the multivariate model. A total of 15,686 patients diagnosed with SNHL were enrolled in the study group while another 31,372 non-SNHL individuals served as the control group. There were 444 glaucoma events in the study group and 647 glaucoma events in those non-SNHL individuals after the follow-up interval of 16 years. The study group demonstrated a significantly higher aHR compared to the control group after adjusting for multiple possible risk factors. In the subgroup analysis, both the normal tension glaucoma and angle closure glaucoma subgroups revealed a higher aHR in the study group. In conclusion, the patients with SNHL demonstrated a higher incidence of developing glaucoma. Moreover, the incidence was more prominent for patients diagnosed with normal tension glaucoma and angle closure glaucoma.

Association of Age Related Macular Degeneration and Age Related Hearing Impairment

Purpose:

To evaluate the association between age-related macular degeneration (ARMD) and sensory neural hearing impairment (SHI).

Methods:

In this case-control study, hearing status of 46 consecutive patients with ARMD were compared with 46 age-matched cases without clinical ARMD as a control group. In all patients, retinal involvements were confirmed by clinical examination, fluorescein angiography (FA) and optical coherence tomography (OCT). All participants were examined with an otoscope and underwent audiological tests including pure tone audiometry (PTA), speech reception threshold (SRT), speech discrimination score (SDS), tympanometry, reflex tests and auditory brainstem response (ABR).

Results:

A significant (P = 0.009) association was present between ARMD, especially with exudative and choroidal neovascularization (CNV) components, and age-related hearing impairment primarily involving high frequencies. Patients had higher SRT and lower SDS against anticipated presbycusis than control subjects. Similar results were detected in exudative, CNV and scar patterns supporting an association between late ARMD with SRT and SDS abnormalities. ABR showed significantly prolonged wave I and IV latency times in ARMD (P = 0.034 and 0.022, respectively). Average latency periods for wave I in geographic atrophy (GA) and CNV, and that for wave IV in drusen patterns of ARMD were significantly higher than controls (P = 0.030, 0.007 and 0.050, respectively).

Conclusion:

The association between ARMD and age-related SHI may be attributed to common anatomical components such as melanin in these two sensory organs.

Contribution of complement factor H Y402H polymorphism to sudden sensorineural hearing loss risk and possible interaction with diabetes

Sudden sensorineural hearing loss (SSNHL) is one of the most common diseases encountered by otolaryngologists; however, the etiology is unclear. The aim of this study was to assess the association between SSNHL and polymorphism of complement factor H (CFH) Y402H, which is implicated in age-related macular degeneration. We conducted a case-control study, in which the cases were 72 SSNHL patients and the controls were 2161 residents selected randomly from the resident register. The odds ratio (OR) for SSNHL risk was determined using the additive-genetic model of CFH Y402H polymorphism. The OR for SSNHL risk was 1.788 (95% confidence interval [CI]: 1.008-3.172) with no adjustments and 1.820 (CI: 1.025-3.232) after adjusting for age and sex. Of the three lifestyle-related diseases hypertension, dyslipidemia, and diabetes, only diabetes was significantly associated with SSNHL risk. We classified both the controls and SSNHL patients into those with or without diabetes, and the OR for SSNHL risk was 6.326 (CI: 1.885-21.225) in diabetic subjects and 1.214 (CI: 0.581-2.538) in nondiabetic subjects. We conclude that CFH Y402H polymorphism and SSNHL risk are significantly related, and that diabetic CFH Y402H minor allele carriers may be susceptible to SSNHL.