Mayo Clinic School of Medicine, Rochester, Minnesota.
Departments of Ophthalmology.
Retina. 2020 May;40(5):857-865. doi: 10.1097/IAE.0000000000002506.
The relationship between age-related macular degeneration (AMD) and malignancy, especially cutaneous malignancies, is not well studied. We investigated a possible association between AMD and cutaneous malignancies.
A retrospective, consecutive review of all patients who had received at least 1 intravitreal injection for wet AMD between January 1, 2004, and December 31, 2013, was conducted using the Rochester Epidemiology Project in Olmsted County, Minnesota. Age- and sex-matched control groups included 473 pre-anti-vascular endothelial growth factor era wet AMD patients, 504 concurrent time dry AMD patients, and 504 patients with no AMD. The rates of AMD and overall malignancy, cutaneous malignancies, and specific types of cutaneous malignancies were compared between groups of patients.
Patients with wet AMD incurred an increased rate of overall malignancies compared to patients with dry AMD {52.8% wet AMD (confidence interval [CI]: 48.3-57.2) vs. 43.7% dry AMD (CI: 39.3-48.1); P= 0.003} or those without AMD (52.8% wet AMD [CI: 48.3-57.2] vs. 35.3% no AMD [CI: 31.1-39.7]; P = <0.001). Patients with dry AMD also had higher rates of malignancy than those without AMD (43.7% dry AMD [CI: 39.3-48.1] vs. 35.3% no AMD [CI: 31.1-39.7]; P = 0.007). Rate of cutaneous malignancies was increased in patients with wet AMD compared to patients with dry AMD (24.4% wet AMD [CI: 20.7-28.4] vs. 14.6% dry AMD [CI: 11.5-17.9]; P = <0.001) and those with no AMD (24.4% wet AMD [CI: 20.7-28.4] vs. 9.7% no AMD [CI: 7.3-12.7]; P = <0.001).
To the best of our knowledge, this is the first report to establish an association between AMD and cutaneous malignancies, supporting a possible discussion of the association when a patient presents with one of the two conditions.
年龄相关性黄斑变性(AMD)与恶性肿瘤,特别是皮肤恶性肿瘤之间的关系尚未得到充分研究。我们研究了 AMD 与皮肤恶性肿瘤之间可能存在的关联。
使用明尼苏达州罗切斯特流行病学项目对 2004 年 1 月 1 日至 2013 年 12 月 31 日期间至少接受过 1 次玻璃体内抗血管内皮生长因子治疗湿性 AMD 的所有患者进行了回顾性、连续的病例对照研究。年龄和性别匹配的对照组包括 473 名在抗血管内皮生长因子时代之前患有湿性 AMD 的患者、504 名同期患有干性 AMD 的患者和 504 名无 AMD 的患者。比较各组患者的 AMD 和总体恶性肿瘤、皮肤恶性肿瘤和特定类型的皮肤恶性肿瘤的发生率。
与患有干性 AMD 的患者相比,患有湿性 AMD 的患者总体恶性肿瘤发生率更高{湿性 AMD 患者为 52.8%(置信区间[CI]:48.3-57.2),干性 AMD 患者为 43.7%(CI:39.3-48.1);P=0.003},与无 AMD 的患者相比也更高{湿性 AMD 患者为 52.8%(CI:48.3-57.2),无 AMD 患者为 35.3%(CI:31.1-39.7);P<0.001}。患有干性 AMD 的患者的恶性肿瘤发生率也高于无 AMD 的患者{干性 AMD 患者为 43.7%(CI:39.3-48.1),无 AMD 患者为 35.3%(CI:31.1-39.7);P=0.007}。与患有干性 AMD 的患者相比,患有湿性 AMD 的患者的皮肤恶性肿瘤发生率更高{湿性 AMD 患者为 24.4%(CI:20.7-28.4),干性 AMD 患者为 14.6%(CI:11.5-17.9);P<0.001},与无 AMD 的患者相比也更高{湿性 AMD 患者为 24.4%(CI:20.7-28.4),无 AMD 患者为 9.7%(CI:7.3-12.7);P<0.001}。
据我们所知,这是第一项确定 AMD 与皮肤恶性肿瘤之间存在关联的报告,支持在患者出现其中一种疾病时讨论两者之间可能存在的关联。