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Vivienne Fang, Atalie C Thompson, Eric J Schwaber, Maria Gomez-Caraballo, Sandra S Stinnett, Heather E Whitson, Eleonora M Lad; Co-prevalence of Alzheimer’s Disease and Age-Related Macular Degeneration Established by Histopathologic Diagnosis. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2264.
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Previous epidemiologic studies have suggested an association between age-related macular degeneration (AMD) and Alzheimer’s disease (AD), and several therapeutic agents are being developed based on this principle. However, prior studies have provided conflicting results due to their reliance on clinical diagnoses that are not based on gold-standard histopathology and failure of severe AMD and AD patients to present for clinical care. The goal of our study is to use histopathologic diagnostic standards to determine the true co-prevalence of AD among patients with and without AMD. Our hypothesis was that the prevalence of AD would be significantly higher in autopsy patients with AMD than those without AMD.
This was a cross-sectional study of 157 eyes from decedent patients at Duke University Medical Center with and without AMD that presented for autopsy examination that were greater than 75 years of age. Sarks staging was used to assess the severity of AMD (defined as Sarks stage 3 and higher), and Braak and Braak staging was used to assess the severity of AD (defined as Braak and Braak stage 3 and higher) in corresponding brain specimens. The prevalence of AD within different severities of AMD was determined using univariable and multivariable logistic regression.
58% (N=91) of the 157 autopsy eyes analyzed had AMD. The prevalence of AD was lower in AMD subjects (63%) compared to non-AMD subjects (73%), even when grouped by severity (all p>0.15). The likelihood of AD was significantly less in AMD subjects, even after adjusting for age and sex in multivariable analysis (OR 0.47, p=0.049).
Histopathologic analyses failed to support an increase in prevalence of AD among subjects with AMD, even when disease severity is considered, suggesting that any shared mechanisms between AMD and AD may be nondeterministic.
This is a 2020 ARVO Annual Meeting abstract.
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