September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Decreased Renal Function is Associated with Reticular Macular Disease (RMD) in Patients with Age-Related Macular Degeneration (AMD)
Author Affiliations & Notes
  • Heather Leisy
    Ophthalmology, New York University, New York, New York, United States
  • Meleha Ahmad
    Ophthalmology, New York University, New York, New York, United States
  • Michael Marmor
    Medicine, New York University, New York, New York, United States
  • Theodore Smith
    Ophthalmology, New York University, New York, New York, United States
  • Footnotes
    Commercial Relationships   Heather Leisy, None; Meleha Ahmad, None; Michael Marmor, None; Theodore Smith, None
  • Footnotes
    Support  Research to Prevent Blindness (no grant #); Foundation Fighting Blindness (grant #BR-CL-0612-0575-NYU)
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Heather Leisy, Meleha Ahmad, Michael Marmor, Theodore Smith; Decreased Renal Function is Associated with Reticular Macular Disease (RMD) in Patients with Age-Related Macular Degeneration (AMD). Invest. Ophthalmol. Vis. Sci. 201657(12):.

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

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Abstract

Purpose : The cause of RMD, a subphenotype of AMD defined by the presence of subretinal drusenoid deposits (SDD) on spectral domain optical coherence tomography (SD-OCT), is still controversial. Because a choroidal etiology is suspected in RMD, and given the similar anatomy of capillary networks in the kidney and choroid,1 we hypothesized that RMD and renal dysfunction share a common pathogenesis2 of decreased organ perfusion. The purpose is to compare renal function in AMD patients with and without RMD through a retrospective chart review.

Methods : We performed a retrospective chart review of patients, from the ophthalmology service of a single large city hospital, who were assigned an ICD-9 code associated with AMD between January 2012 and September 2015 and who had SD-OCT imaging and GFR studies. SD-OCT images were evaluated for the presence of RMD in each eye, and patients with ≥1 SDD in at least one eye were deemed RMD+. We used SAS version 9.3 to calculate: (1) the odds ratio (OR) and 95% confidence interval (CI) for poor (GFR < 60) vs. normal renal function (GFR ≥ 60) as a risk factor for RMD; (2) an exact test for trend to evaluate odds of being RMD+ as renal function decreased.

Results : We identified 99 patients (age range: 46-101 years). RMD+ patients were older (median age: 79, range: 50-101) than RMD- patients (median age: 69, range: 46-88) (P=0.0002). To obtain similar age distributions between groups, we restricted analyses to 86 patients aged 50-89 years. GFR < 60 was found in 40% (19/47) of those with RMD vs. 15% (5/39) of those without RMD and was a significant risk factor for RMD (OR=4.6, 95% CI=1.5-13). The odds of being RMD+ increased significantly as GFR decreased (P=0.014).

Conclusions : This is the first study to compare renal function to RMD status in an AMD population. The current analysis shows an association of RMD with renal dysfunction and is consistent with a choroidal etiology of RMD.

1. Hayreh SS. In vivo choroidal circulation and its watershed zones. Eye (Lond). 1990;4(Pt2): 273-89.
2. Liew G, Mitchell P, Wong TY, Iyengar SK, Wang JJ. CKD increases the risk of age-related macular degeneration. J Am Soc Nephrol. 2008;19:806-11

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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