Risk Factors for Age-Related Macular Degeneration

Abstract

Abstract: : Purpose: To evaluate the association between age-related macular degeneration (AMD) and diet, alcohol intake, medications, and smoking. Methods: One hundred one AMD patients and 102 controls with other eye conditions were identified from the clinical database of the Hunter Holmes McGuire Veterans Administration Medical Center, Richmond, VA. A detailed questionnaire including diet, alcohol intake, smoking, and medication history was completed for each participant. A medical record review was conducted to identify body mass index, major medical conditions, and use of systemic medications. The ocular examination was recorded, and AMD was graded according to the Age-Related Eye Disease Study (AREDS) classification. Univariate and multivariable analyses were performed. Results: The mean age was 77 years for cases and 74 for controls. The mean AREDS stage in the worse eye was 2.7 for cases. Diabetes and glaucoma were more common in the control subjects. Blue irides were associated with macular degeneration in a univariate analysis (p < 0.001). Use of Hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) for greater than 1 year was less common in cases (39%) compared with controls (56%, p = 0.01). The independent predictors of the severity of macular degeneration by multivariable linear regression were age (p = 0.001), family history (p < 0.001), white race (p < 0.001), pack-years of cigarette smoking (p = 0.04), and years of statin treatment (p = 0.002). Statin treatment was negatively associated. Alcohol use and fruit and vegetable intake were not associated with macular degeneration Conclusions: In our series, the following risk factors were associated with AMD: age, race, family history, cigarette smoking, and absence of statin treatment. Smoking is an avoidable risk factor for AMD and patients should be counseled about the ocular risks of cigarette smoking. Statins may be protective against severe AMD, and a prospective trial may be indicated.

Keywords: retina • age-related macular degeneration • clinical (human) or epidemiologic studies: ris