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Sam Khandhadia, Andrew J. Lotery; Prevalence Of AMD In A Liver Transplant Cohort. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1233.
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A cohort of liver transplanted patients was recruited, to investigate whether systemic gene therapy in the form of liver transplant can influence the risk of developing age-related macular degeneration (AMD). Of note, the liver is the predominant site of complement protein production in the body. This includes complement factor H (CFH), a regulator of the alternate complement pathway. Mutations in the CFH gene, have been strongly associated with AMD. The primary study hypothesis is that systemic replacement of a mutated CFH gene with a wild-type copy, via liver transplant, can reduce the risk of developing AMD. The prevalence of AMD in this cohort, is presented.
Patients over 55 years old of Caucasian origin with a history of liver transplantation at least 5 years previously were recruited at 4 specialist liver transplant centres in the UK, over an 18 month period. Dilated fundus examination and photos were taken for AMD grading via a standard scale (Age-Related Eye Disease Study AREDS grading). Bloods were also taken for recipient genotyping, and donor tissue retrieved for donor genotyping.
197 patients with gradable eyes have been recruited to date. The mean age (+/- 1 SD) was 66.8 +/- 5.9 years, and the mean duration post liver transplant 11.8 +/- 4.5 years. The prevalence of AMD in either eye (grades 2-5) was 52.7% (see figure 1)
This is the first report of the prevalence of AMD in a liver transplant cohort. AMD seems to be more prevalent in this cohort than in the normal population. This may be the result of systemic illness. Alternately receipt of a liver with varying CFH gene status to that originally in the recipient may influence the risk of developing AMD.
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