The Relationship of Treated Hypertension with Geographic Atrophy and Neovascular- Age Related Macular Degeneration in a Colorado cohort.

Abstract

Purpose : Age-related macular degeneration (AMD) is one of the leading causes of blindness. Studies have shown that hypertension is associated with late AMD in at least one eye; however, little is known of the risk of treated hypertension among patients with bilateral geographic atrophy (GA) or bilateral neovascular- AMD (NV-AMD). The purpose of this study was to assess the risk of treated hypertension with bilateral GA and bilateral NV-AMD in a Colorado cohort.

Methods : A case control study was performed. Cases were patients with bilateral GA (n=15) or bilateral NV- AMD (n=27) identified using records and multimodal imaging techniques from the Colorado Age-Related Macular Degeneration Registry (July 2014 to 2015). Controls were patients with age-related cataract with no AMD (n = 61). We compared the prevalence of treated hypertension in cases and controls using univariate analysis (Chi-squared or Fisher’s exact; univariate logistic regression for continuous variables (p <.05)). We used multivariable logistic regression to estimate the odds ratio of treated hypertension for the outcomes adjusted for a history of cardiac disease, age, and sex. The statistical analysis was performed using SAS 9.4.

Results : We found 7/15 patients (46.67%) with bilateral GA, 20/27 (74.07%) with bilateral NV-AMD, and 27/61 (44.26%) of controls who had treated hypertension. The median age (range) was 80.4 years (58.7-93.8), 83 years (58.9-93.8) and 72.4 years (50.6-90.2) for GA, NV-AMD, and cataract controls, respectively. Treated hypertension was associated with NV-AMD (OR: 3.59 [95% Confidence Interval (CI): 1.33-9.76] p=.010), but was not associated with GA (OR: 1.10 [95%Cl: 0.35-3.42] p=.868). The adjusted odds ratios of treated chronic hypertension for bilateral GA and bilateral NV-AMD were 0.79 [95% CI: 0.10-6.51] and 4.67 [95% CI: 0.92-23.45], respectively. Compared to patients with GA, the adjusted odds ratio of treated hypertension for NV-AMD was 3.02 ([95%Cl: 0.59-15.32] p=.183).

Conclusions : We found higher odds for NV-AMD in patients with treated hypertension. In contrast, we found lower odds of GA in patients with treated hypertension as compared to age-related cataract controls with no AMD.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.