Neovascular age-related macular degeneration is not associated with coronary heart disease in a Chinese Population: a population-based study

Cross-sectional study of the association between cataract surgery and age-related macular degeneration in the era of phacoemulsification in the national health and nutrition examination survey 2005-2008

OBJECTIVE

To determine the association between cataract surgery and age-related macular degeneration (AMD) in a representative US sample.

DESIGN

Population-based, cross-sectional study.

SETTING

The US National Health and Nutrition Examination Survey 2005-2008.

PARTICIPANTS

A total of 5401 participants aged ≥40 years had information in cataract surgery status and gradable retinal photographs for right eyes.

METHODS

Cataract surgery status was obtained from questionnaire. Non-mydriatic fundus photographs were collected and AMD status was assessed. The associations between AMD and cataract surgery were evaluated in right eyes using logistic regression models.

RESULTS

Of 338 right eyes with any AMD, 107 right eyes (28.9%) had cataract surgery. After adjusting for multiple variables, there were significant associations between cataract surgery and any AMD (OR 1.36; 95% CI 1.03 to 1.81) or late AMD (OR 2.48; 95% CI 1.01 to 6.09). No significant association was found between cataract surgery and early AMD after adjusting for multiple covariates (OR 1.20; 95% CI 0.91 to 1.59).

CONCLUSION

Our results suggest that cataract surgery is associated with the presence of AMD, particularly for late AMD. Longitudinal studies investigating the risk and progression of AMD after cataract surgery are needed in the era of phacoemulsification.

Adherence to a Mediterranean diet, lifestyle and age-related macular degeneration: the Coimbra Eye Study - report 3

PURPOSE

To characterize the lifestyle and nutritional risk profile associated with the Mediterranean diet in a Portuguese population with and without age-related macular degeneration (AMD).

METHODS

Nested case-control study (n = 883) within the Coimbra Eye Study, including 434 subjects with AMD and 449 age- and sex-matched subjects without AMD. All enrolled subjects underwent a full risk assessment, including lifestyle-related risk factors and a thorough food frequency questionnaire. This allowed us to build an adherence score to the Mediterranean diet (mediSCORE, range 0-9) constructed from individual food intakes. Food intake was also further analysed by conversion to micronutrient consumption.

RESULTS

Our results suggest that physical activity has a protective role in AMD [p = 0.018 after multivariate adjustment, OR: 0.69 (0.51-0.93)]. High (mediSCORE ≥6) was also found to be protective [p = 0.041, OR: 0.62 (95% CI: 0.38-0.97)]. Food group analysis unveiled a specific protective role for increased fruits consumption (p = 0.029). Finally, micronutrient analysis revealed a protective role associated with increased consumption of caffeine, fibres, beta-carotene, vitamin C and vitamin E (p < 0.05).

CONCLUSION

High mediSCORE appears to confer protection against the development of AMD in a Mediterranean population. This effect is driven by increased consumption of fruits and some antioxidant micronutrients, which emerged as statistically significant protective factors. Further studies are required to establish dietary recommendations with clinical application.

Neovascular age-related macular degeneration is associated with cataract surgery

PURPOSE

This retrospective cohort study examines the association between cataract surgery and neovascular age-related macular degeneration (AMD) during 5-year follow-up using population-based claims data.

METHODS

We analysed data sourced from the Taiwan Longitudinal Health Insurance Database 2005. The study included 3465 patients who had undergone cataract operations and did not have a diagnosis of AMD before or on the surgery date (study group), and 10 395 age- and sex-matched comparison patients selected randomly from the remaining patients without an AMD diagnosis before the index date. We tracked the claims of each patient for a 5-year period to identify patients with a subsequent diagnosis of neovascular AMD.

RESULTS

The incidence rate of neovascular AMD was 0.88 (95% confidence interval (CI): 0.66-1.14) per 1000 person-years among all sampled patients, 1.60 (95% CI: 1.04-2.36) among the cataract surgery patients and 0.64 (95% CI: 0.43-0.91) among comparison patients (p < 0.001). Stratified Cox proportional analysis showed that relative to the comparison cohort, the adjusted hazard ratio for neovascular AMD during 5-year follow-up was 2.68 (95% CI: 1.55-4.66) for patients who had undergone cataract operation. We censored those who died during follow-up period and adjusted for patients' monthly income, geographical location, urbanization level, diabetes, hypertension, cardiovascular disease and hyperlipidaemia.

CONCLUSION

This study demonstrated epidemiological evidence of a link between cataract surgery and neovascular AMD during a 5-year follow-up period.

New neovascular age-related macular degeneration is associated with systemic leucocyte activity

PURPOSE

To investigate systemic leucocyte activity in subtypes of age-related macular degeneration (AMD) and onset of neovascular AMD.

METHODS

Patients with early and late AMD and age-matched control individuals were recruited consecutively, and venous blood was sampled for differential leucocyte counts. Patients with neovascular AMD were grouped based on time of blood sampling in relation to diagnosis of neovascular AMD: diagnosis of new neovascular AMD more than 30 days before blood sampling, within 30 days of blood sampling and more than 30 days after blood sampling.

RESULTS

Of 347 recruited participants, 330 fulfilled the eligibility criteria (77 age-matched controls, 33 with early AMD, 56 with geographic atrophy and 164 with neovascular AMD). We did not find any differences in the differential counts between patients at different stages of AMD and age-matched control individuals. However, lymphocyte and monocytes-basophils-eosinophils mixed (MXD) counts were both significantly increased in patients with new neovascular AMD. Among these patients; higher MXD correlated with lower BCVA, larger central foveal thickness and larger total lesion size; higher lymphocytes correlated with smaller total lesion size; higher neutrophils correlated with CNV lesion size; and higher neutrophil-to-lymphocyte ratio correlated with larger lesion size.

CONCLUSIONS

Systemic leucocyte activity is associated with onset of CNV in patients with AMD and correlate with lesion size and BCVA, which suggest that acute systemic immune activity may play a role in neovascular flaring of AMD.