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Austin Fox, Catherine A Cukras, Nirali Bhatt, William R Tucker, Robert B Nussenblatt, H Nida Sen; Age-Related Macular Degeneration among Uveitis Patients. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5323.
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To evaluate the prevalence of Age-Related Macular Degeneration (AMD) among uveitis patients.
Patients with non-infectious uveitis 55 years or older seen at NEI since 2004 were identified using EMR and photographic databases. Color fundus photos, fundus autofluorescence, fluorescein angiography, and optical coherence tomography were reviewed by two separate examiners. Patients were classified as having “any AMD” if they had large drusen or advanced AMD (geographic atrophy (GA) or neovascular AMD (NV AMD)) in at least one eye according to The Eye Diseases Prevalence Research Group’s definition.
182 patients were identified, and 171 had gradable fundus images. Forty-seven had anterior uveitis, 41 intermediate uveitis and 83 posterior or panuveitis. Average age was 64.2±7.7 years, 66.1% were female, majority were non-Hispanic White (51.5%) and 38.6% were African American. AMD was identified in 9 of the 171 patients, and all cases were in the form of large drusen. Of these 9 patients, 4 had anterior uveitis, 3 intermediate uveitis and 2 posterior or panuveitis. The total prevalence of “any AMD” was 5.26 per 100 individuals, which is less than the estimated overall prevalence of “any AMD” or large drusen in the US for individuals ≥55 years of age (12.8% and 10.0%, respectively; p=0.001 and 0.019). Advanced AMD was present in 0 out of 171 patients which was also significantly lower (0% vs 2.8%; p=0.008).
Patients with uveitis appear to be relatively spared from AMD, especially from its advanced forms. It is not clear whether this is due to underlying disease process or long-term anti-inflammatory use among uveitis patients.
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