Fernandez Antonio B, Panza Gregory A, Cramer Benjamin, Chatterjee Saurav, Jayaraman Ramya, Wu Wen-Chih
Division of Cardiology, Hartford Hospital, Hartford, Connecticut, United States of America.
University of Connecticut, School of Medicine, Farmington, CT, United States of America.
PLoS One. 2015 Nov 18;10(11):e0142968. doi: 10.1371/journal.pone.0142968. eCollection 2015.
Age-related macular degeneration (AMD) is the leading cause of vision loss and blindness in people over 65 years old in the United States and has been associated with cardiovascular risk and decreased survival. There is conflicting data, however, regarding the contribution of AMD to the prediction of stroke.
To determine whether AMD is a risk indicator for incident stroke in a meta-analysis of available prospective and retrospective cohort studies published in the English literature.
We performed a systematic literature search of all studies published in English with Pub Med and other databases from 1966 to August 2014, reporting stroke incidence in patients with macular degeneration. Two investigators independently extracted the data. A random effects model was used to report Odds ratios (OR), with corresponding 95% confidence intervals (CI). Meta-regression using a mixed linear model was used to understand potential heterogeneity amongst studies.
We identified 9 studies that reported stroke incidence in patients with and without early AMD (N = 1,420,978). No significant association was found between early AMD with incident stroke. Combined, these 9 studies demonstrated random effects (OR, 1.12; CI, 0.86-1.47; I2 = 96%). Meta-regression on baseline covariates of age, sex, and year of publication did not significantly relate to heterogeneity.
We found no significant relationship between AMD and incident stroke. Further studies are needed to clarify other causes of decreased survival in patients with AMD.
年龄相关性黄斑变性（AMD）是美国65岁以上人群视力丧失和失明的主要原因，并且与心血管风险及生存率降低有关。然而，关于AMD对中风预测的贡献，数据存在冲突。
在对英文文献中发表的现有前瞻性和回顾性队列研究进行的荟萃分析中，确定AMD是否为新发中风的风险指标。
我们对1966年至2014年8月期间在PubMed和其他数据库中发表的所有英文研究进行了系统的文献检索，报告黄斑变性患者的中风发病率。两名研究人员独立提取数据。使用随机效应模型报告比值比（OR）及相应的95%置信区间（CI）。使用混合线性模型进行荟萃回归以了解各研究之间潜在的异质性。
我们确定了9项报告有或无早期AMD患者中风发病率的研究（N = 1,420,978）。未发现早期AMD与新发中风之间存在显著关联。这9项研究综合显示随机效应（OR，1.12；CI，0.86 - 1.47；I² = 96%）。对年龄、性别和发表年份等基线协变量进行的荟萃回归与异质性无显著相关性。
我们发现AMD与新发中风之间无显著关系。需要进一步研究以阐明AMD患者生存率降低的其他原因。
