Abstract
Abstract: :
Purpose: Our previous study [ARVO 2004, E–Abstract 2998] investigated the relationship between the magnitude of retinal hemodynamic abnormalities in patients with age–related macular degeneration (AMD) and the degree of severity of the disease, and suggested that an increasing vascular rigidity in the systemic arterial circulation may be associated with an increasing severity of AMD. In the present study, we investigated whether there is an association between the actual, directly measured, systemic arterial stiffness and the presence of AMD. Methods: Assessment of the systemic arterial stiffness was performed noninvasively using a SphygmoCor 2000 system (AtCor Medical, Sydney, Australia) to measure the pulse wave velocity (PWV). Measurement sites were at the radial and carotid arteries. The Sphygmocor system was also used to determine the central aortic blood pressure waveform, which is derived from the radial artery measurements. We studied 21 patients with AMD (4 males, 17 females, ages 60 to 87 years, mean 78 years) and 9 age–matched control subjects (2 males, 7 females, ages 66 to 92 years, mean 73 years). All study subjects received a complete ophthalmic examination including digital fundus photography. All of the patients with AMD were classified as stage 3 or worse in at least one eye according to the AREDS system. Statistical comparisons were made using unpaired t–tests. Results: PWV was significantly higher in the patients with AMD (8.2 ± 1.1 m/s, mean ± sd) compared to controls (7.0 ± 0.8 m/s, p = 0.010) indicating increased arterial stiffness. Central aortic systolic blood pressure was also significantly higher in AMD (149 ± 20 mmHg) compared to controls (126 ± 20 mmHg, p = 0.013), as was central aortic pulse pressure (69 ± 20 mmHg in AMD) compared to controls (49 ± 4.3 mmHg, p = 0.018). Mean brachial artery blood pressure was 108 ± 2.8 mmHg in AMD, and 96 ± 5.1 mmHg in controls, p = 0.017. Conclusions: Patients with AMD have a higher central aortic pulse pressure and an increased arterial stiffness compared to age–matched controls. These results suggest that factors often associated with systemic vascular disease are also related to an increased risk for the presence of AMD.
Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: risk factor assessment • aging