Age-Related Macular Degeneration and the Risk of Stroke

Abstract

Background and Purpose-Age-related macular degeneration (AMD) and stroke are both frequent diseases in the elderly.A link between AMD and stroke has been suggested, because both disorders have many risk factors in common. The aim of this study was to investigate the association between AMD and stroke and the subtypes cerebral infarction and intracerebral hemorrhage in the general elderly population. Methods-This study was part of the population-based Rotterdam Study and included 6207 participants aged Ն55 years who were stroke-free at baseline (1990 to 1993). Signs of AMD were assessed on fundus photographs at baseline and at regular follow-up examinations and were categorized in 5 stages (0 to 4) representing an increasing severity. Late AMD (Stage 4) was subdivided into dry and wet AMD. Follow-up for incident stroke was complete up to January 1, 2007. Data were analyzed using time-dependent Cox regression models adjusted for age, sex, and potential confounders. Results-During a median follow-up of 13.6 years, 726 participants developed a stroke (397 cerebral infarction, 59intracerebral hemorrhage, 270 unspecified). Late AMD was associated with an increased risk of any stroke (hazard ratio, 1.56; 95% CI, 1.08 to 2.26) due to a strong association with intracerebral hemorrhage (hazard ratio, 6.11; 95% CI, 2.34 to 15.98). In contrast, late AMD was not associated with cerebral infarction. Earlier AMD stages were not associated with risk of stroke or any of its subtypes. Conclusions-We found that late AMD is strongly associated with intracerebral hemorrhage, but not with cerebral infarction, in the general elderly population. (Stroke. 2011;42:2138-2142.)

Age-Related Macular Degeneration and the Incidence of Cardiovascular Disease: A Systematic Review and Meta-Analysis

“…In the Rotterdam Eye Study where RRs were reported across graded stage of AMD (stage 0–4, with stage 1–3 being early AMD and 4 being late AMD) [22], we used generalized least-squares trend estimation (GLST) [23] method to estimate the log-linear dose-response slope within stage 0 to 3 to approximate the overall RR associated with early AMD. The RR provided for the fourth stage of AMD would then represent the association of late AMD with CVD.…”

Relation between Age-Related Macular Degeneration and Cardiovascular Events and Mortality: A Systematic Review and Meta-Analysis

“…After detailed examination, 7 literatures were excluded (reasons shown in Figure 3). In total, 20 articles [6–9, 14–29] were included, and the full list of publications is shown in Table 1.…”

“…AMD and CVD may connote shared underlying pathophysiological factors (e.g., advancing age, smoking, obesity, C-reactive protein, Apo lipoprotein E gene, and complement factor H) [3, 5]. But epidemiological studies have not found a consistent association of AMD and CVD [6–9], although a previous systematic review [10] including 13 population-based studies concluded that there is an association between AMD and CVD risk and suggested that AMD is predictive of a small increase in risk of future CVD. Thirteen cohort studies with a total of 1,593,390 participants with 155,500 CVD events (92,039: stroke and 62,737: CHD) were included in previous systematic review.…”

Observation on health quality of life before and after the injection of antiangiogenic drug in vitreous cavity to patients with wet age-related macular degeneration

“…Clinically, for patients with wet AMD, all of the different treatment methods can get a certain effect, but each treatment has risks, for example, although the photodynamic therapy (PDT) can effectively control the disease progression, it also effects the restoration of visual function 6,7 , which requires actively and effectively communication and explanation with patients prior to treatment; Another treatment method is intravitreal injection of anti-VEGF drug, this treatment can improve vision while no form of obvious scars in the macula 8 , thereby it has an important role of restoring visual function and improving visual quality, however, this method also has its disadvantage, that is approximately 0.05% of the patients occurs with endophthalmitis 9 , about approximately 0.01% of the patients will have stroke or cerebrovascular accident 10,11 . From our research result, 3 patients end up having poor therapeutic effect, the reasons are as follows: complications occur after a variety of M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 6 drug injection, such as vitreous hemorrhage, lesion obvious scarring, as well as latent wet-AMD patients have a poor sensitivity toward anti-VEGF drugs.…”