Wang Sarah B, Mitchell Paul, Chiha Joseph, Liew Gerald, Plant Adam J H, Thiagalingam Aravinda, Burlutsky George, Gopinath Bamini
Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia.
Centre for Heart Research, Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia.
Br J Ophthalmol. 2015 Mar;99(3):365-70. doi: 10.1136/bjophthalmol-2014-305793. Epub 2014 Sep 23.
BACKGROUND/AIMS: To describe the prevalence of early, late and any age-related macular degeneration (AMD) in a clinical cohort (Australian Heart Eye Study, AHES) and to determine whether associations exist between extent and severity of coronary artery disease (CAD) and AMD, independent of traditional cardiovascular risk factors.
The AHES is an observational study that surveyed 1680 participants between 2009 and 2012 who presented to a tertiary referral hospital for the evaluation of potential CAD by coronary angiography. Severity and extent of CAD was assessed using three scoring systems: (1) segment/vessel scores, (2) Gensini and (3) extent scores.
Prevalence of early and late AMD was 5.8% (n=86) and 1.4% (n=21), respectively. After multivariable adjustment, patients with stenosis >50% in any coronary artery segment (vessel score) had approximately twofold higher odds of early AMD, OR 1.95 (95% CI 1.07 to 3.57). Patients with obstructive coronary stenosis in all three main coronary arteries (segment score) had greater than twofold higher likelihood of early AMD, OR 2.67 (95% CI 1.24 to 5.78). Participants in the highest versus lowest tertile of Gensini scores were also twice as likely to have early AMD, multivariable-adjusted OR 2.27 (95% CI 1.12 to 4.58). Extent scores were not associated with AMD. There was no significant association between CAD and late AMD.
Severity of coronary stenosis and the presence of stenotic lesions were independently associated with early AMD. These findings could have potential clinical significance as they suggest that individuals with evidence of CAD may be screened for early AMD.
背景/目的:描述临床队列(澳大利亚心脏眼科研究,AHES)中早期、晚期及任何年龄相关性黄斑变性(AMD)的患病率,并确定冠状动脉疾病(CAD)的范围和严重程度与AMD之间是否存在独立于传统心血管危险因素的关联。
AHES是一项观察性研究,在2009年至2012年间对1680名因冠状动脉造影前来三级转诊医院评估潜在CAD的参与者进行了调查。使用三种评分系统评估CAD的严重程度和范围:(1)节段/血管评分,(2)Gensini评分,(3)范围评分。
早期和晚期AMD的患病率分别为5.8%(n = 86)和1.4%(n = 21)。多变量调整后,任何冠状动脉节段狭窄>50%(血管评分)的患者患早期AMD的几率约高出两倍,比值比(OR)为1.95(95%置信区间[CI]为1.07至3.57)。所有三支主要冠状动脉均存在阻塞性冠状动脉狭窄(节段评分)的患者患早期AMD的可能性高出两倍多,OR为2.67(95% CI为1.24至5.78)。Gensini评分处于最高三分位数与最低三分位数的参与者患早期AMD的可能性也高出两倍,多变量调整后的OR为2.27(95% CI为1.12至4.58)。范围评分与AMD无关。CAD与晚期AMD之间无显著关联。
冠状动脉狭窄的严重程度和狭窄病变的存在与早期AMD独立相关。这些发现可能具有潜在的临床意义,因为它们表明有CAD证据的个体可能需要筛查早期AMD。