June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
The Association Between Reticular Macular Disease (RMD) and Coronary Artery Disease (CAD)
Author Affiliations & Notes
  • Patrick A Kaszubski
    Ophthalmology, New York University School of Medicine, New York, NY
  • Colleen Cunningham
    Ophthalmology, New York University School of Medicine, New York, NY
  • Vivek Kumar
    Ophthalmology, New York University School of Medicine, New York, NY
  • Camellia Nabati
    Ophthalmology, New York University School of Medicine, New York, NY
  • Rachel M Cymerman
    Ophthalmology, New York University School of Medicine, New York, NY
  • Theodore Smith
    Ophthalmology, New York University School of Medicine, New York, NY
  • Footnotes
    Commercial Relationships Patrick Kaszubski, None; Colleen Cunningham, None; Vivek Kumar, None; Camellia Nabati, None; Rachel Cymerman, None; Theodore Smith, Advanced Cell Technologies (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 5162. doi:
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      Patrick A Kaszubski, Colleen Cunningham, Vivek Kumar, Camellia Nabati, Rachel M Cymerman, Theodore Smith; The Association Between Reticular Macular Disease (RMD) and Coronary Artery Disease (CAD). Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5162.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Reticular Macular Disease (RMD), a leading risk factor for disease progression in Age-Related Macular Degeneration (AMD), demonstrates both subretinal drusenoid deposits (SDD) and choroidal alterations (vascular involvement). The goal of this study was to compare the prevalence of SDD in subjects aged 30-75 years who have documented cardiovascular disease, specifically CAD, to the established prevalence of RMD by color fundus photography (CP) in the general population (Beaver Dam Eye Study (BDES)) [Klein, R. Am J Ophthalmology 2008]. CAD is a condition that can strike in middle age, while AMD affects the elderly. A middle-aged CAD cohort allows a search for early SDD that could link CAD and AMD/RMD.

 
Methods
 

47 consecutive subjects with documented CAD (ages 40 to 75 years), were enrolled from a cardiology clinic at a large city public hospital. Before undergoing enhanced depth imaging spectral domain optical coherence tomography (EDI SD-OCT) imaging, all subjects completed a questionnaire regarding medical and ocular history. A retina specialist evaluated the images for evidence of SDD and other retinal findings. Chi-square goodness of fit was used for statistical analysis.

 
Results
 

In a cohort of 30 male and 17 female subjects with CAD, the mean age was 63.5 years (range 44-75). 9 subjects (19.15%) had evidence of SDD on EDI SD-OCT, significantly greater than the known population prevalence by CP of 0.7% (P=<0.001). Allowing for the decreased sensitivity of CP (about 35%) for RMD compared to EDI SD-OCT, significance is still maintained (P=<0.001). Examples of EDI-OCT imaging from a subject with CAD, and a normal control, are demonstrated in Figure 1.

 
Conclusions
 

While previous studies have shown an overlap between AMD and CAD risk factors, the choroidal alterations of RMD are more strongly indicative of a vascular etiology and thus a potential link to CAD. Our results clearly demonstrate an increased prevalence of SDD among our CAD sample when compared to the prevalence in the general population established by the BDES. These results suggest that RMD and CAD may share a common pathophysiology.  

 
Figure 1:<br /> Top: Normal 75 year old female. Bottom: 59 year old male with CAD. The subretinal space is marked by yellow asterisks. Note SDD in bottom panel.
 
Figure 1:<br /> Top: Normal 75 year old female. Bottom: 59 year old male with CAD. The subretinal space is marked by yellow asterisks. Note SDD in bottom panel.

 
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