April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Impact of Fellow Eye on Incidence, Progression and Regression of Age-Related Macular Degeneration: Results from Multi-state Models Applied to the Beaver Dam Eye Study
Author Affiliations & Notes
  • Ronald Gangnon
    Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI
  • Kristine E Lee
    Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
  • Barbara E K Klein
    Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
  • Sudha K Iyengar
    Case Western Reserve University, Cleveland, OH
  • Theru A Sivakumaran
    Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
  • Ronald Klein
    Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
  • Footnotes
    Commercial Relationships Ronald Gangnon, None; Kristine Lee, None; Barbara Klein, None; Sudha Iyengar, None; Theru Sivakumaran, None; Ronald Klein, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 6004. doi:
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      Ronald Gangnon, Kristine E Lee, Barbara E K Klein, Sudha K Iyengar, Theru A Sivakumaran, Ronald Klein; Impact of Fellow Eye on Incidence, Progression and Regression of Age-Related Macular Degeneration: Results from Multi-state Models Applied to the Beaver Dam Eye Study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6004.

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

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Abstract

Purpose: To investigate the impact of severity of age-related macular degeneration (AMD) in the fellow eye on incidence, progression and regression of AMD.

Methods: Analyses included 4,379 persons aged 43 to 86 years at the time of initial examination. AMD status in each eye was graded on a five-step severity scale from retinal photographs taken at up to 5 study visits between 1988 and 2010. Multi-state models in continuous time were used to model the effects of age, sex, complement factor H (CFH) genotype, and AMD severity in the fellow eye on incidence, progression, and regression of AMD and mortality.

Results: More severe AMD in the fellow eye was associated with increased incidence of AMD (hazard ratio 4.90, 95% confidence interval 4.26-5.63) and progression of AMD (Level 2 to 3: 2.09, 1.42-3.06; Level 3 to 4: 2.38, 1.74-3.25; Level 4 to Late AMD: 2.46, 1.65-3.66), but not with regression of AMD. Less severe AMD in the fellow eye was associated with decreased progression of AMD (Level 2 to 3: 0.42, 0.33-0.55; Level 3 to 4: 0.50, 0.34-0.83) and increased regression of AMD (Level 3 to 2: 2.00, 1.12-3.58; Level 4 to 3: 8.97, 1.01-80.1). Older age was associated with increased incidence of AMD (1.40 per 10 years, 1.35-1.45), progression of AMD (Level 2 to 3: 1.28, 1.20-1.38; Level 3 to 4: 1.11, 1.04-1.19; Level 4 to Late AMD: 1.22, 1.11-1.33), regression of AMD (Level 2 to 1: 1.12, 1.05-1.20; Level 3 to 2: 1.17, 1.03-1.33) and mortality (1.67, 1.63-1.71). Male sex was associated with mortality (1.55, 1.42-1.68), but not with incidence, progression, or regression of AMD. CFH genotype CC was associated with increased incidence of AMD (1.94, 1.62-2.33), progression of AMD (Level 2 to 3: 1.63, 1.18-2.25; Level 4 to Late AMD: 1.57, 1.01-2.46), but not with regression of AMD or mortality relative to the TT genotype. Late AMD in both eyes was associated with increased mortality (1.28, 1.03-1.58).

Conclusions: Using multi-state models, we show that AMD severity in one eye tracks AMD severity in its fellow eye.

Keywords: 412 age-related macular degeneration • 461 clinical (human) or epidemiologic studies: natural history • 463 clinical (human) or epidemiologic studies: prevalence/incidence  
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