Purpose
To examine the association between periodontal disease and age-related macular degeneration (AMD).
Methods
Data from The National Health and Nutrition Examination Survey III (NHANES III) was utilized to conduct secondary analysis. Survey participants provided blood samples, were interviewed for demographic, behavioral, and medical information, and also underwent a physical and oral examination. Retinal images obtained during the study were graded using standardized protocols to measure AMD. Early and late AMD diagnoses were combined to create a global variable of "any AMD". Periodontal disease was modeled using pocket depth measurements obtained during the oral examination portion of the NHANES III survey. Serum CRP levels, alongside other clinical measure were also analyzed. Univariate and multivariate analysis were performed to test association between oral health and AMD.
Results
Out of 9737 fundus photographs obtained during the survey, 940 (9.65%) had AMD with 885 (9.09%) early AMD and 55 (0.56%) late AMD. Stratifying for age (people <60 years of age vs. ≥ 60 years of age) and adjusting for confounding variables, poor periodontal status was significantly associated with high risk for AMD (odds ratio=1.937; 95% confidence interval: 1.192-3.149; p=0.009) in the population under the age of 60. There was no significant association between periodontal status and AMD in people ≥60 years of age. In persons aged <60 years, there was also a statistically significant difference in mean CRP levels between those with poor periodontal status vs. those without. No such significant difference in CRP levels was found in those ≥60 years of age.
Conclusions
Poor periodontal health, as measured by pocket depth, increases the risk of developing AMD in persons under the age of 60. Such association is not seen in those above the age of 60, which suggests that proper oral care at a younger age may play a role in reducing the risk of developing AMD.
Keywords: 412 age-related macular degeneration •
464 clinical (human) or epidemiologic studies: risk factor assessment •
688 retina