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Douglas A Jabs, Mark L Van Natta, Ronald P Danis, Jeong Pak, Peter Hunt; Incidence of Age-Related Macular Degeneration in Patients with the Acquired Immune Deficiency Syndrome. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1623.
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Patients with the Acquired Immune Deficiency Syndrome (AIDS) have an estimated 4-fold increased age-adjusted prevalence of intermediate-stage age-related macular degeneration (AMD). We investigated the incidence of intermediate-stage AMD in patients with AIDS.
Participants in the Longitudinal Study of the Ocular Complications of AIDS (LSOCA) cohort study (all of whom had AIDS and no ocular infections) had follow-up photographs taken at 5 and 10 years after enrollment. Photographs were graded in a masked fashion at a centralized imaging reading center using the Age-Related Eye Disease Study-2 (AREDS-2) scoring system. The main outcome measure was intermediate-stage AMD. The incidence of AMD in LSOCA was compared to the published incidence in an HIV-uninfected cohort, the Multi-Ethnic Study of Atherosclerosis (MESA) study, which used a similar photographic methodology. The comparison was race- and gender-adjusted using Poisson regression.
Follow-up photographs were available on 717 participants in LSOCA. The demographic distribution of the population was: 52% non-Hispanic white, 34% non-Hispanic African American, 13% Hispanic, and 1% Asian; 83% men and 17% women. The mean (+/- standard deviation) age of this population was 44 +/- 8 years. 4.7% of particiipants developed intermediate-stage AMD during follow-up. The incidence of intermediate-stage AMD was 6.5/1000 person-years (PY). The mean age of the comparator MESA cohort was 61 +/- 9 years. The race- and gender-adjusted relative risk for AMD in the LSOCA cohort compared to the MESA cohort was 1.75 (95% confidence interval 1.16-2.64), P=0.008.
There was an apparent 75% greater incidence of intermediate-stage AMD in patients with AIDS compared to an HIV-unifected cohort. These data are consistent with with the accentuated aging seen in antiretroviral-treated, immunorestored, HIV-infected persons, which may be related to the immunosenescence, immune activation, and systemic inflammation seen in these patients.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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