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U. Chakravarthy, R. E. Hogg, J. V. Woodside, A. E. Fletcher, W. Chan, A. Knox; Cardiovascular Disease and Hypertension Are Strong Risk Factors for Choroidal Neovascularisation. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1442.
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.To investigate the association of cardiovascular risk factors and inflammatory markers with neovascular age-related macular degeneration (AMD)
Cases (195) with neovascular AMD in at least one eye were recruited from hospital eye clinics . Other participants (n = 205 people) aged 65 years and over were recruited through a population based survey . Clinic and community participants underwent a detailed ophthalmic examination with fundus imaging, were interviewed for assessment of risk factors and provided a blood sample. All participants were classified by fundus image grading on the basis of the eye with more severe AMD features.
There were 195 participants with choroidal neovascularisation in at least one eye, 97 non neovascular AMD and 115 controls (no drusen or pigmentary irregularities in either eye). In confounder adjusted logistic regression, a history of cardiovascular disease was strongly associated with neovascular AMD (OR 7.53 (CI 2.78-20.41)). Cigarette smoking (OR 3.71, CI 1.25-11.06), being in the highest quartile of BMI (OR 3.82 , CI 1.22-12.01), grade 2 hypertension (OR 3.21 CI 1.14-8.98), and being in the highest quartile of serum cholesterol (4.66 CI 1.35-16.13) were positively associated with neovascular AMD. There was no association between AMD status and serum VCAM or ICAM.
Our results strongly suggest that cardiovascular disease is an etiological factor in the development of choroidal neovascularisation in a proportion of older adults and highlight the importance of control of blood pressure and cholesterol, avoidance of smoking and maintenance of a normal body weight
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