Association between asymmetry in cataract and asymmetry in age-related macular degeneration. The Beijing Eye Study

Xu, Liang; You, Qi Sheng; Cui, Tongtong; Jonas, Jost B.

doi:10.1007/s00417-010-1571-y

Cited by 16 publications

(13 citation statements)

References 43 publications

(45 reference statements)

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“…Although cataract surgery has been found to be a risk factor for AMD in Caucasian populations [2], this does not appear to be the case in Asians [72]. Iris pigmentation is another inconsistent risk factor, with some studies in Caucasian populations reporting an association of lighter colored iris with AMD [73].…”

Section: Risk Factorsmentioning

confidence: 99%

Polypoidal Choroidal Vasculopathy in Asians

Wong

Cheung

2015

JCM

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Age related macular degeneration (AMD) in Asians has been suggested to differ from their Western counterparts in terms of epidemiology, pathogenesis, clinical presentation and treatment. In particular, polypoidal choroidal vasculopathy (PCV) appears to be the predominant subtype of exudative AMD in Asian populations, in contrast to choroidal neovascularization secondary to AMD (CNV-AMD) in Western populations. Epidemiological data on PCV has been largely limited to hospital-based studies and there are currently no data on the incidence of PCV. Similarities and differences in risk factor profile between PCV and CNV-AMD point to some shared pathogenic mechanisms but also differential underlying mechanisms leading to the development of each phenotype. Serum biomarkers such as CRP, homocysteine and matrix metalloproteinases suggest underlying inflammation, atherosclerosis and deranged extracellular matrix metabolism as possible pathogenic mechanisms. In addition, recent advances in genome sequencing have revealed differences in genetic determinants of each subtype. While the standard of care for CNV-AMD is anti-vascular endothelial growth factor (VEGF) therapy, photodynamic therapy (PDT) has been the mainstay of treatment for PCV, although long-term visual prognosis remains unsatisfactory. The optimal treatment for PCV requires further clarification, particularly with different types of anti-VEGF agents and possible benefits of reduced fluence PDT.

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Section: Risk Factorsmentioning

confidence: 99%

Polypoidal Choroidal Vasculopathy in Asians

Wong

Cheung

2015

JCM

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“…[12][13][14][15] In addition, these results have been derived primarily from white populations; a paucity of data addresses the potential association in Asian populations. 16,17 In addition to inherent differences, such as iris color and retinal pigment epithelial darkness, which may influence AMD pathogenesis in relation to cataract surgery, AMD characteristics are quite different between Asian and white individuals. Early signs of AMD (eg, drusen) are less common in Asian than in white patients, and polypoidal choroidal vasculopathy, a distinct subtype of exudative AMD, accounts for 20% to 55% of exudative AMD in Asian populations, whereas it accounts for only 8% to 13% in white populations.…”

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confidence: 99%

Cataract Surgery and Age-Related Macular Degeneration in the 2008-2012 Korea National Health and Nutrition Examination Survey

et al. 2016

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In the past, concern has been raised that cataract surgery may be associated with the incidence or progression of age-related macular degeneration (AMD); inconsistent findings from previous studies have puzzled clinicians. In addition, data addressing this association in Asian populations and in the era of phacoemulsification are scarce. OBJECTIVE To determine the associations between cataract surgery and AMD in a representative Korean population. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used a multistage, probability-cluster survey sample to produce nationally representative estimates. Data were analyzed from the Korea National Health and Nutrition Examination Survey (KNHANES), which included results for cataract surgery status and AMD grading from 2008 to 2012. A total of 20 419 participants 40 years or older were included. Data were analyzed from February 5 to August 20, 2015. MAIN OUTCOMES AND MEASURES The association between cataract surgery and AMD was assessed in each right and left eye using logistic regression models and in both eyes using generalized estimating equation models. Sample weights were applied to adjust for survey design, nonresponse, and stratification to generate nationally representative population-based results. RESULTS From the 20 419 eligible individuals (11 642 women [51.9%] and 5777 men [48.1%]; mean [SE] age, 55.83 [0.14] years), 17 987 had information regarding cataract surgery status and gradable fundus photographs of at least 1 eye. A total of 34 863 eyes (17 616 right eyes and 17 247 left eyes) underwent analysis. Of these, 1264 right eyes (5.5%) and 1235 left eyes (5.4%) had cataract surgery. Of 1056 right eyes and 949 left eyes with any AMD (early or late), 167 right eyes (15.2%) and 147 left eyes (13.7%) had cataract surgery. The analyses did not show any association between cataract surgery and any form of AMD (early, late, and all) except in left eyes, where cataract surgery was associated with late AMD (odds ratio, 2.34; 95% CI, 1.13-4.85). CONCLUSIONS AND RELEVANCE The results suggest that the association between cataract surgery and AMD is uncertain in the current era of phacoemulsification. The association for left eyes might be a chance finding.

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“…17 However, neither cataract nor cataract surgery were associated with either early or late AMD in the Beijing Eye Study. 18 Thus, there is no clear consensus as to whether cataract surgery is associated with increased risk of AMD and, if so, whether this is due to confounding by indication (presence of cataract) or due to an effect of cataract that is further exacerbated by cataract surgery. The purpose of this paper is to elucidate these relationships in the context of the BDES, a long term ongoing study of age-related eye conditions over 20 years of follow-up.…”

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confidence: 99%

The Relationship of Cataract and Cataract Extraction to Age-related Macular Degeneration: The Beaver Dam Eye Study

et al. 2012

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Objective To examine the associations of cataract and cataract surgery with early and late age-related macular degeneration (AMD) over a 20-year interval. Design Longitudinal population-based study of age-related eye diseases. Participants: Beaver Dam Eye Study participants. Methods All persons 43-84 years of age were recruited in 1987-1988. Participants were followed up at five year intervals after the baseline examination in 1988-1990. Examinations consisted of ocular examination with lens and fundus photography, medical history, measurements of blood pressure, height, and weight. Values of risk variables were updated, and incidences of early and late AMD were calculated for each 5-year interval. Odds ratios were computed using discrete linear logistic regression modeling with generalized estimating equation methods to account for correlation between the eyes and multiple intervals. Main Outcome Measures AMD. Results After controlling for age and sex, neither cataract nor cataract surgery was associated with increased odds for developing early AMD. Further controlling for high risk gene alleles (CFH and ARMS2) and other possible risk factors did not materially affect the odds ratio (OR). However, cataract surgery was associated with incidence of late AMD (OR 1.93; 95% CI 1.28, 2.90). This OR was not materially altered by further controlling for high risk alleles (CFH Y402H, ARMS2) or for other risk factors. The OR for late AMD was higher for cataract surgery performed 5 or more years prior as compared to less than 5 years prior. Conclusions These data strongly support the past findings of an association of cataract surgery with late AMD independent of other risk factors including high risk genetic status, and suggest the importance of considering these findings when counseling patients regarding cataract surgery. These findings should provide further impetus for the search for measures to prevent or delay the development of age-related cataract.

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Association between asymmetry in cataract and asymmetry in age-related macular degeneration. The Beijing Eye Study

Cited by 16 publications

References 43 publications

Polypoidal Choroidal Vasculopathy in Asians

Polypoidal Choroidal Vasculopathy in Asians

Cataract Surgery and Age-Related Macular Degeneration in the 2008-2012 Korea National Health and Nutrition Examination Survey

The Relationship of Cataract and Cataract Extraction to Age-related Macular Degeneration: The Beaver Dam Eye Study

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