Abstract
Purpose :
Age-Related Macular Degeneration (AMD) is a leading cause of severe vision loss in adults over the age of 50 worldwide. Some studies have suggested that emphysema and asthma have links with AMD. However, little is known about whether chronic lung diseases in general are related to the development of AMD. The purpose of this study was to determine if chronic lung disease was associated with AMD in a Colorado AMD cohort.
Methods :
A case-control study was performed using records from the Colorado AMD Registry (July 2014-Oct 2019). AMD Cases were categorized into 3 groups: early/intermediate (EI AMD), geographic atrophy (GA AMD), and Neovascular (NV AMD) by two retina specialists using multimodal imaging and the Ferris classification for AMD. Controls were patients receiving age-related cataract surgery with no AMD, confirmed by image review. Chronic lung disease was defined as a diagnosis of asthma, chronic obstructive pulmonary disease (COPD) emphysema, or treatments with bronchodilators or corticosteroids determined via medical record review and patient interview. The frequency of chronic lung disease was compared between cases and controls using univariate and multivariate analysis.
Results :
In total 924 patients were included in the study, of which 272 (29.4%) were EI AMD, 113 (12.2%) GA AMD, 318 (34.4%) NV AMD, and 221 (23.9%) were controls. The number of cases with chronic lung disease in EI AMD, GA, NV AMD, and controls was 54 (19.8%), 15 (13.3%), 74 (23.3%) and 33(14.9%) respectively. The mean age of cases with EI AMD, GA, NV AMD and controls was 76.2 (±7.2), 81.9 (±7.6), 80.3 (±8.5) and 72.8 (±5.8). Cases were more likely to be Caucasian (95% versus 85%). The incidence of current cigarette smoking in the cohort was low at 3.4%. In the univariate analysis we found a significant relationship of chronic lung disease with NV AMD (OR (95% CI): 1.73 (1.1-2.7), p=0.017). There was some attenuation of the OR following adjusting for age and race (OR: 1.58, 95% CI: 0.96-2.61 p=0.07). The adjusted OR (95%CI) of chronic lung disease for E/I AMD and GA was 1.41 (0.9-2.3), p=0.15 and 0.87 (0.5-1.7), p=0.68.
Conclusions :
Patients in our Colorado cohort with NV AMD phenotype were more likely to have chronic lung disease compared to controls with no AMD. Moving forward, with a greater sample size we will continue to examine the relationship between forms of lung disease and different phenotypes of AMD.
This is a 2020 ARVO Annual Meeting abstract.