Age-related Macular Degeneration Is Associated with Atherosclerosis

Vingerling, J. R.; Dielemans, Ida; Bots, Michiel L.; Hofman, Albert; Grobbee, Diederick E.; Jong, Paulus T. V. M. de

doi:10.1093/oxfordjournals.aje.a117648

Cited by 315 publications

(177 citation statements)

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“…1,[16][17][18][19][20] In fact, as shown in Table 1, a number of our study patients with AMD were being treated for these disorders. Smoking, hypertension, and elevated serum cholesterol have been shown to be risk factors for both AMD and cardiovascular disease.…”

Section: Discussionmentioning

confidence: 99%

Retinal haemodynamics in patients with age-related macular degeneration

Satô

Feke

Menke

et al. 2005

Eye

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Objective To investigate whether there is an association between the magnitude of retinal haemodynamic abnormalities in patients with age-related macular degeneration (AMD) and the degree of severity of the AMD. Methods A retinal laser Doppler system (Canon CLBF 100) was used to measure retinal arterial haemodynamic parameters in 25 eyes of 25 patients with AMD and nine eyes of nine age-matched control subjects. Severity of AMD was classified into Mild (n ¼ 11), Moderate (n ¼ 7), or Severe (n ¼ 7). The pulsatility ratio (PR), the pulsatility index (PI), and the resistivity index (RI) were determined. Results PR, PI, and RI in the patients with AMD were each significantly higher than in the control group, and increased monotonically with increasing severity of AMD. However, there were no differences in mean blood velocity, arterial diameter, or blood flow rate among the groups. This suggests that the increased blood flow pulsatility in the retinal arteries of the eyes with AMD is not due to increased distal vascular resistance, but instead is likely due to a loss of compliance in the arterial vasculature leading to the eye. Conclusion Our results suggest that an increasing vascular rigidity in the systemic arterial circulation is directly associated with an increasing severity of AMD.

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Section: Discussionmentioning

confidence: 99%

Retinal haemodynamics in patients with age-related macular degeneration

Satô

Feke

Menke

et al. 2005

Eye

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“…The prevalence of both AMD and cardiovascular disease are strongly age-dependent, but there are conflicting reports about the independent associations of cardiovascular disease, its risk factors and AMD. Factors such as hypertension, (4-10) previous vascular events, (9,(11)(12)(13)(14)(15) obesity, (4,11,(16)(17)(18)(19) and diabetes (11,20,21) have been significantly associated with early and advanced AMD in several studies. Hypertension and atherosclerosis have been hypothesized by Friedman (22) to increase the risk of AMD through the reduction of blood flow through the choroidal vasculature and lipid deposition in Bruch's membrane with a reduction of permeability leading to the upregulation of vascular endothelial derived growth factor.…”

Section: Introductionmentioning

confidence: 99%

“…(26) Most data on the association between various cardiovascular risk factors and AMD have been derived from studies among non-Hispanic Whites. (4)(5)(6)(7)(8)11,13,(15)(16)(17)(18)(19)(20)(21) To date, there have been few published risk factor analyses of AMD and cardiovascular disease and cardiovascular risk factors among Latinos. (9,10,12,14) The Latino population is the largest minority group in the United States (US) and the fastest growing segment of the US population.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Risk Factors and Age-related Macular Degeneration: The Los Angeles Latino Eye Study

Fraser‐Bell

Klein

et al. 2008

American Journal of Ophthalmology

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Purpose-To assess the association of cardiovascular risk factors, ocular perfusion pressure with early and advanced age-related macular degeneration (AMD) in Latinos.Design-Population-based, cross-sectional study.Methods-Data were collected from a population-based sample of self-identified adult Latinos using standardized protocols for assessing blood pressure and intraocular pressure (IOP) measurement and stereoscopic macular photography. Hypertension was defined as either a history of hypertension or systolic blood pressure (SBP) >140mmHg +/− diastolic blood pressure (DBP) ≥85mmHg. Ocular perfusion pressure (OPP) was defined as the difference between mean arterial blood pressure and IOP. AMD was diagnosed from photographic grading by masked trained graders. Logistic regression was used to assess associations.Results-Gradable retinal photographs were available in 5875 participants. After adjusting for age, sex, and cigarette smoking, higher DBP and uncontrolled diastolic hypertension were associated with exudative AMD (Odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1−2.8; and OR, 3.3; CI, 1.2 −9.3, respectively). Higher OPP was associated with a decreased risk of GA (OR, 0.4 per 10mmHg; CI, 0.3−0.5). Low pulse pressure was associated with a lower risk of exudative AMD (OR, 0.2; CI, 0.1−0.6). Obesity was associated with increased retinal pigment (OR, 1.6; CI, 1.0−2.3). Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusion-These data suggest that in Latinos cardiovascular risk factors may play a role in advanced AMD. Given that Latinos have a high prevalence of cardiovascular risk factors, an intervention aimed at reducing these risk factors may also have a beneficial impact on the risk of having early and advanced AMD. NIH Public Access

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“…Successful transfer of lipids to nascent apo B regulates whether apo B is secreted in a mature lipoprotein particle or degraded via the ubiquitin-proteasome system. 28 -30 Patients with CVD history or symptoms have increased risk for ARM 31,32 (G. McGwin, C. Owsley, C.A. Curcio, R.J. Crain, submitted), and CVD and ARM have common risk factors (age, smoking, and hypertension).…”

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confidence: 99%

Apolipoprotein B in Cholesterol-Containing Drusen and Basal Deposits of Human Eyes with Age-Related Maculopathy

Malek

Guidry

et al. 2003

The American Journal of Pathology

239

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Lipids accumulate in Bruch's membrane (BrM), a specialized vascular intima of the eye, and in extracellular lesions associated with aging and age-related maculopathy (ARM). We tested the hypothesis that ARM and atherosclerotic cardiovascular disease share molecules and mechanisms pertaining to extracellular lipid accumulation by localizing cholesterol and apolipoprotein B (apo B) in BrM, basal deposits, and drusen. Human donor eyes were preserved <4 hours postmortem and cryosectioned. Sections were stained with traditional lipid stains and filipin for esterified and unesterified cholesterol or probed with antibodies to apo B, apo E, and apo C-III. Normal adult retinal pigment epithelium (RPE) was subjected to RT-PCR and Western blot analysis for apolipoprotein mRNA and protein. Esterified and unesterified cholesterol was present in all drusen and basal deposits of ARM and normal eyes. Both apo B and apo E but not apo C-III were found in BrM, drusen, and basal deposits. Age-related maculopathy (ARM) is the leading cause of new, untreatable vision loss in the elderly in Western societies. [1][2][3] As shown in Figure 1A, ARM involves the retinal pigment epithelium (RPE, cells dedicated to sustaining photoreceptor health), the choriocapillaris (the blood supply to photoreceptors and the RPE), and Bruch's membrane (BrM, a thin vascular intima between the RPE and choriocapillaris). 4,5 Early ARM is characterized by moderate vision loss associated with characteristic extracellular lesions. Lesions between the RPE basal lamina and BrM can be focal (drusen) or diffuse (basal linear deposits). A diffuse lesion between the RPE and its basal lamina is basal laminar deposit. The term "sub-RPE deposits" is used for the combination of drusen and basal deposits and "basal deposits" for the combination of basal laminar deposit and basal linear deposit. Late ARM is characterized by severe vision loss associated with extensive RPE atrophy with or without the sequelae of choroidal neovascularization, ie, in-growth of choriocapillaries through BrM and under the RPE in the plane of drusen and basal linear deposits. Because the causes of ARM are obscure, recent studies have sought molecules present in the affected tissues and characteristic lesions to identify biochemical pathways perturbed by disease. 6 An important but incompletely characterized component of BrM and sub-RPE deposits is lipids. Normal BrM accumulates lipids with age, and the accumulation of esterified and unesterified cholesterol (EC and UC)-containing particles is especially prominent in the macula. 7-10 Drusen and basal deposits in aged eyes without ARM contain lipids, including cholesterol, 9 -13 and current evidence suggests that individual sub-RPE deposits are preferentially enriched in either neutral lipids or polar lipids. 13 The source of lipids and mechanisms of deposition are unknown. Analyses of BrM/ choroid lipid composition have implicated both local cells and plasma. 8,9 Atherosclerotic cardiovascular disease (CVD), the leading cause of death in Wester...

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Age-related Macular Degeneration Is Associated with Atherosclerosis

Cited by 315 publications

References 0 publications

Retinal haemodynamics in patients with age-related macular degeneration

Retinal haemodynamics in patients with age-related macular degeneration

Cardiovascular Risk Factors and Age-related Macular Degeneration: The Los Angeles Latino Eye Study

Apolipoprotein B in Cholesterol-Containing Drusen and Basal Deposits of Human Eyes with Age-Related Maculopathy

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