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Jiyong Kwak, Tyler Hyungtaek Rim, Tae Keun Yoo, Sung Eun Kim, Dong Wook Kim, Sung Soo Kim; Association of medications and neovascular age-related macular degeneration: National Sample Cohort 2010-2015. Invest. Ophthalmol. Vis. Sci. 2019;60(9):59. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Previous epidemiological studies have shown a possible increased risk of neovascular AMD in individuals who regularly take aspirin. However, there has not been an epidemiological study investigating the effect of various other prescribed medication on neovascular AMD on a population level. We performed a retrospective population-based study using a nationwide cohort to investigate the association between different medications and neovascular AMD.
Subjects above age 45 from National Health Insurance Service Health Screening Cohort was included in this study. In year 2009, these subjects included 482,613 individuals. We tracked these individuals from 2010 to 2015 and generated hazard ratios (HRs) from Cox regression models with 95% confidence intervals (CIs). Among top 500 most-frequently prescribed drugs, 67 drugs that showed statistically significant results from univariate Cox regression were included in multivariate Cox regression analysis with factors including, age, sex, place of residence, and income level.
From 2010 to 2015, 900 neovascular AMD patients were newly registered to the cohort. Mean age of patients with neovascular AMD (67.7±9.5) was 10 years older than those without neovascular AMD (56.4±11.2). Multivariate analysis showed 8 statistically significant drugs that were positively associated with incidence of neovascular AMD. They included oxycodone (HR = 2.44 [95% CI, 0.97–6.10], triazolam (HR = 2.41 [95% CI, 1.11–5.26], hydroxyzine (HR = 2.76 [95% CI, 1.55–4.92], labetalol (HR = 2.37 [95% CI, 1.20–4.70], carvedilol (HR = 2.08 [95% CI, 1.00–4.33], pseudoephedrine (HR = 1.73 [95% CI, 1.06–2.82], methocarbamol (HR = 2.47 [95% CI, 1.01–6.06], and amikacin sulfate (HR = 1.39 [95% CI, 1.00–1.92]. Oxygen gas (HR = 0.66 [95% CI, 0.45–0.97] showed negative association with neovascular AMD.
We found association between incidence of neovascular AMD and certain frequently prescribed medications. Oxycodone, triazolam, hydroxyzine, labetalol, carvedilol, pseudoephedrine, methocarbamol, and amikacin sulfate showed positive association, whereas oxygen gas showed negative association with neovascular AMD. This first population-based study should be followed by large-scale and long term follow up study and may serve as a guideline for prescribing medications for patients at risk for neovascular AMD in the future.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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