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Samuel Taylor, Chase Paulson, Christian James Pompoco, Karen Curtin, Brian Craig Stagg, Robert Ritch, Barbara M Wirostko; Association of Age-related Macular Degeneration with Exfoliation Syndrome: The Utah Project on Exfoliation Syndrome. Invest. Ophthalmol. Vis. Sci. 2021;62(8):181.
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Exfoliation syndrome (XFS) is associated with COPD, obstructive sleep apnea, hernias, and atrial fibrillation. Studies suggest XFS may share pathogenetic relationships with age-related macular degeneration (AMD) due to underlying elastin and basement membrane dysfunction and repair. A retrospective analysis was conducted to assess the association between XFS and AMD.
Subjects were identified in the University of Utah Healthcare System (UUHCS) with an XFS diagnosis (ICD-9 codes 365.52 and 366.11) from 1996-2015. A conditional logistic regression accounting for individual matching on age and sex and adjusted for race, ethnicity, obesity, smoking history, and hypertension history was performed. The risk of AMD was estimated in patients age ≥60y on 1/1/1996 (when electronic records became available) with an ICD-9 AMD diagnosis: 362.50 (unspecified/presumed nonexudative (‘dry’) if no history of exudative (‘wet’) AMD, 362.51 (dry AMD), 362.52 (wet AMD), 362.57 (drusen). Random non-XFS UUHCS controls matched 5:1 on age and sex comprised the comparison group for assessing AMD risk in this cross-sectional analysis.
Of 3,082 UUHCS patients with an XFS diagnosis, 562 (18.2%) were positive for a diagnosis of any type of AMD. Of 15,418 controls, 1,160 had a history of any type of AMD (7.5%) (OR= 2.79; 95% CI= 2.47-3.10; P<0.0001). 245 (8.0%) of XFS patients and 347 (2.3%) of controls had a diagnosis history of wet AMD (OR=3.76; 95% CI= 3.16-4.47; P<0.0001). 300 (9.7%) XFS patients and 765 (5.0%) controls had a diagnosis of dry AMD (OR= 2.03; 95% CI= 1.76-2.34; P<0.0001). In XFS patients, increased risk of a wet AMD diagnosis was significantly higher than that of dry AMD (non-overlapping confidence intervals). Drusen, a very small group, was not analyzed separately.
XFS patients may have an increased risk of both wet and dry AMD compared to those without XFS. The increased risk of AMD associated with XFS was greater for wet AMD than dry AMD. XFS patients need to be followed closely for both AMD and glaucoma. Continued data analysis will explore associations at an individual eye level.
This is a 2021 ARVO Annual Meeting abstract.
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