Pulmonary Disease and Age-Related Macular Degeneration

Abstract

To examine the association of pulmonary symptoms, disease, and function with the incidence of age-related macular degeneration (AMD). Design: Population-based cohort study of persons aged 43 to 86 years at baseline (N=4926), of whom 3779 participated in 1 or more follow-up examinations. Methods: Stereoscopic photographs of the macula were graded to determine the presence of AMD. Existence of emphysema, asthma, and respiratory symptoms was determined from subjects' medical history questionnaires; the peak expiratory flow rate was measured using a Mini-Wright Peak Flow Meter (Clement Clarke International, Harlow, England). Discrete logistic hazard and logistic regression models were used. Main Outcome Measures: Incidence and progression of AMD. Results: While controlling for age, sex, and other factors, a history of emphysema at baseline was found to be associated with the 15-year cumulative incidence of increased retinal pigment (odds ratio, 2.08; 95% confidence interval, 1.06-4.06), retinal pigment epithelium depigmentation (2.40; 1.23-4.67), and exudative AMD (3.65; 1.24-10.73). Mild pulmonary symptoms were associated with the 5-year incidence of exudative AMD (odds ratio, 3.83; 95% confidence interval, 1.39-10.58), and the fourth (ie, highest) quartile of pulmonary expiratory flow rate showed a protective effect for progression of AMD among women (0.36; 0.15-0.86). Conclusion: Independent of smoking, a history of emphysema and respiratory symptoms and function are modestly but inconsistently associated with the incidence and progression of AMD.

COVID-19 Morbidity and Severity in Patients With Age-Related Macular Degeneration: A Korean Nationwide Cohort Study

“… 9 Furthermore, pulmonary disorders, such as emphysema, and the presence of the respiratory symptoms were associated with exudative AMD in the cohorts of the Beaver Dam Eye Study, suggesting mutual interaction between chronic lung disease and exudative AMD. 10 Since AMD serves as a biomarker of biological aging and chronic CNS inflammation 7 , increased risk of mortality in patients with exudative AMD in our cohort strongly supports that inflammaging might be one of the risk factors for severe clinical outcomes of COVID-19. 23 However, future studies involving other inflammaging-related neurodegenerative diseases (e.g.…”

COVID-19 Morbidity and Severity in Patients With Age-Related Macular Degeneration: A Korean Nationwide Cohort Study

“… 9 Furthermore, pulmonary disorders, such as emphysema, and the presence of the respiratory symptoms were associated with exudative AMD in the cohorts of the Beaver Dam Eye Study, suggesting mutual interaction between chronic lung disease and exudative AMD. 10 Since AMD serves as a biomarker of biological aging and chronic CNS inflammation 7 , increased risk of mortality in patients with exudative AMD in our cohort strongly supports that inflammaging might be one of the risk factors for severe clinical outcomes of COVID-19. 23 However, future studies involving other inflammaging-related neurodegenerative diseases (e.g.…”

Patterns of Multimorbidity in the Aged Population. Results from the KORA-Age Study

“…Finally, eye and lung diseases co-occurred significantly more often than expected. This finding contributes to the current controversial discussion about a relation between the systemic inflammation and/or decreased systemic oxygenation associated with lung diseases and the risk of age-related macular degeneration [35] , [36] . An additional potential explanation for this finding could be the reported increased risk of cataracts associated with long-term use of corticosteroids in the treatment of asthma [37] .…”

Genome-wide association study and identification of systemic comorbidities in development of age-related macular degeneration in a hospital-based cohort of Han Chinese

“…The results revealed that non-exudative AMD had no association with asthma (OR = 1.06, 95% CI = 0.86-1.27), other lung diseases (OR = 1.08, 95% CI = 0.90-1.29), or spirometry parameters, including forced expiratory volume in 1 s (FEV 1 ), forced vital capacity (FVC), and peak expiratory flow rate, after adjustments were made for age, gender, smoking, and hypertension (Moorthy et al, 2011). However, a population-based cohort study involving 4,926 participants showed that having an emphysema history at baseline was associated with a 15-year cumulative incidence of increased retinal pigment (OR = 2.08, p = 0.03), RPE depigmentation (OR = 2.40, p = 0.01), and exudative AMD (OR = 3.65, p = 0.02), upon adjusting for age, gender, history of smoking, body mass index, and white blood cell count at baseline (Klein et al, 2008). Apart from the respiratory diseases, there were epidemiological studies yielding inconclusive results on the correlation between hypertension and AMD (Katsi et al, 2015).…”

COVID-19 Morbidity and Severity in Patients With Age-Related Macular Degeneration: A Korean Nationwide Cohort Study

“… 9 Furthermore, pulmonary disorders, such as emphysema, and the presence of the respiratory symptoms were associated with exudative AMD in the cohorts of the Beaver Dam Eye Study, suggesting mutual interaction between chronic lung disease and exudative AMD. 10 Since AMD serves as a biomarker of biological aging and chronic CNS inflammation 7 , increased risk of mortality in patients with exudative AMD in our cohort strongly supports that inflammaging might be one of the risk factors for severe clinical outcomes of COVID-19. 23 However, future studies involving other inflammaging-related neurodegenerative diseases (e.g.…”

Patterns of Multimorbidity in the Aged Population. Results from the KORA-Age Study

“…Finally, eye and lung diseases co-occurred significantly more often than expected. This finding contributes to the current controversial discussion about a relation between the systemic inflammation and/or decreased systemic oxygenation associated with lung diseases and the risk of age-related macular degeneration [35] , [36] . An additional potential explanation for this finding could be the reported increased risk of cataracts associated with long-term use of corticosteroids in the treatment of asthma [37] .…”

Genome-wide association study and identification of systemic comorbidities in development of age-related macular degeneration in a hospital-based cohort of Han Chinese

“…The results revealed that non-exudative AMD had no association with asthma (OR = 1.06, 95% CI = 0.86-1.27), other lung diseases (OR = 1.08, 95% CI = 0.90-1.29), or spirometry parameters, including forced expiratory volume in 1 s (FEV 1 ), forced vital capacity (FVC), and peak expiratory flow rate, after adjustments were made for age, gender, smoking, and hypertension (Moorthy et al, 2011). However, a population-based cohort study involving 4,926 participants showed that having an emphysema history at baseline was associated with a 15-year cumulative incidence of increased retinal pigment (OR = 2.08, p = 0.03), RPE depigmentation (OR = 2.40, p = 0.01), and exudative AMD (OR = 3.65, p = 0.02), upon adjusting for age, gender, history of smoking, body mass index, and white blood cell count at baseline (Klein et al, 2008). Apart from the respiratory diseases, there were epidemiological studies yielding inconclusive results on the correlation between hypertension and AMD (Katsi et al, 2015).…”

COVID-19 Morbidity and Severity in Patients With Age-Related Macular Degeneration: A Korean Nationwide Cohort Study

“… 9 Furthermore, pulmonary disorders, such as emphysema, and the presence of the respiratory symptoms were associated with exudative AMD in the cohorts of the Beaver Dam Eye Study, suggesting mutual interaction between chronic lung disease and exudative AMD. 10 Since AMD serves as a biomarker of biological aging and chronic CNS inflammation 7 , increased risk of mortality in patients with exudative AMD in our cohort strongly supports that inflammaging might be one of the risk factors for severe clinical outcomes of COVID-19. 23 However, future studies involving other inflammaging-related neurodegenerative diseases (e.g.…”

Patterns of Multimorbidity in the Aged Population. Results from the KORA-Age Study

“…Finally, eye and lung diseases co-occurred significantly more often than expected. This finding contributes to the current controversial discussion about a relation between the systemic inflammation and/or decreased systemic oxygenation associated with lung diseases and the risk of age-related macular degeneration [35] , [36] . An additional potential explanation for this finding could be the reported increased risk of cataracts associated with long-term use of corticosteroids in the treatment of asthma [37] .…”

Genome-wide association study and identification of systemic comorbidities in development of age-related macular degeneration in a hospital-based cohort of Han Chinese

“…The results revealed that non-exudative AMD had no association with asthma (OR = 1.06, 95% CI = 0.86-1.27), other lung diseases (OR = 1.08, 95% CI = 0.90-1.29), or spirometry parameters, including forced expiratory volume in 1 s (FEV 1 ), forced vital capacity (FVC), and peak expiratory flow rate, after adjustments were made for age, gender, smoking, and hypertension (Moorthy et al, 2011). However, a population-based cohort study involving 4,926 participants showed that having an emphysema history at baseline was associated with a 15-year cumulative incidence of increased retinal pigment (OR = 2.08, p = 0.03), RPE depigmentation (OR = 2.40, p = 0.01), and exudative AMD (OR = 3.65, p = 0.02), upon adjusting for age, gender, history of smoking, body mass index, and white blood cell count at baseline (Klein et al, 2008). Apart from the respiratory diseases, there were epidemiological studies yielding inconclusive results on the correlation between hypertension and AMD (Katsi et al, 2015).…”