Abstract
Purpose :
To investigate the role of non-genetic risk factors for age-related macular degeneration (AMD) in nonagenarians.
Methods :
In this case-control study, between May and November 2014, all people ≥ 90 years were selected from the Cologne city register (n=799) and invited by letter to our clinic for participation in the EUGENDA Study (www.eugenda.org). Grading for presence of AMD was performed on color fundus photographs and spectral-domain optical coherence tomography according to the Beckmann classification system. Participants with other macular diseases or bad image quality were excluded. All patients underwent detailed questionnaires (history of smoking, hypertension, diabetes, physical activity, past sunlight exposure and mental status) and blood samples were taken. Logistic regression analysis for presence of AMD and advanced AMD were performed.
Results :
In total, 109 nonagenarians participated in this study and 103 fulfilled the inclusion criteria (mean age 95.65 ±2.09). No information could be obtained about nonagenarians who did not participate in the trial. From 103 subjects, 77 (74.8%) showed signs of AMD (n=35 early/intermediate AMD; n=42 late AMD). Levels of apolipoprotein B (p=0.01, Odds Ratio (OR): 0.97, 95% Confidence Interval (CI) : 0.95-0.99), low-density lipoprotein (p=0.02, OR: 0.98, 95% CI: 0.97-1.00) and cholesterol (p=0.05, OR: 0.99, 95%CI: 0.97-1.00) were independently associated with presence of AMD as protective factors. The associations were confirmed also in the sub-analysis for presence of late AMD compared to no AMD (apolipoprotein B p=0.01, OR: 0.96, 95%CI: 0.93-0.99; low-density lipoprotein p=0.01, OR: 0.97, 95%CI: 0.95-0.99; cholesterol p=0.03, OR: 0.98, 95%CI: 0.96-1.00).
Conclusions :
This study indicates possible role of metabolic factors for the presence of AMD in the very elderly. Further analysis should be performed to investigate the role of metabolomics as protective factors in the AMD pathogenesis.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.