Department of Neurology, Mayo Clinic, 4500 San Pablo Rd., Jacksonville, FL 32224, United States.
Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, United States.
J Stroke Cerebrovasc Dis. 2023 Aug;32(8):107244. doi: 10.1016/j.jstrokecerebrovasdis.2023.107244. Epub 2023 Jul 7.
Age-related macular degeneration (AMD) is a common retinal degenerative disorder among older individuals. Amyloid deposits, a hallmark of cerebral amyloid angiopathy (CAA), may be involved in the pathogenesis of AMD. Since amyloid deposits may contribute to the development of both AMD and CAA, we hypothesized that patients with AMD have a higher prevalence of CAA.
To compare the prevalence of CAA in patients with or without AMD matched for age.
We conducted a cross-sectional, 1:1 age-matched, case-control study of patients ≥40 years of age at the Mayo Clinic who had undergone both retinal optical coherence tomography and brain MRI from 2011 to 2015. Primary dependent variables were probable CAA, superficial siderosis, and lobar and deep cerebral microbleeds (CMBs). The relationship between AMD and CAA was assessed using multivariable logistic regression and was compared across AMD severity (none vs early vs late AMD).
Our analysis included 256 age-matched pairs (AMD 126, no AMD 130). Of those with AMD, 79 (30.9%) had early AMD and 47 (19.4%) had late AMD. The mean age was 75±9 years, and there was no significant difference in vascular risk factors between groups. Patients with AMD had a higher prevalence of CAA (16.7% vs 10.0%, p=0.116) and superficial siderosis (15.1% vs 6.2%, p=0.020), but not deep CMB (5.2% vs 6.2%, p=0.426), compared to those without AMD. After adjusting for covariates, having late AMD was associated with increased odds of CAA (OR 2.83, 95% CI 1.10-7.27, p=0.031) and superficial siderosis (OR 3.40, 95%CI 1.20-9.65, p=0.022), but not deep CMB (OR 0.7, 95%CI 0.14-3.51, p=0.669).
AMD was associated with CAA and superficial siderosis but not deep CMB, consistent with the hypothesis that amyloid deposits play a role in the development of AMD. Prospective studies are needed to determine if features of AMD may serve as biomarkers for the early diagnosis of CAA.
年龄相关性黄斑变性（AMD）是老年人中常见的视网膜退行性疾病。淀粉样蛋白沉积是脑淀粉样血管病（CAA）的标志，可能与 AMD 的发病机制有关。由于淀粉样蛋白沉积可能导致 AMD 和 CAA 的发展，我们假设 AMD 患者的 CAA 患病率更高。
比较年龄匹配的 AMD 患者和无 AMD 患者的 CAA 患病率。
我们进行了一项横断面、1:1 年龄匹配的病例对照研究，纳入了 2011 年至 2015 年在 Mayo 诊所接受视网膜光学相干断层扫描和脑部 MRI 检查的年龄≥40 岁的患者。主要的因变量是可能的 CAA、表浅铁质沉着症、脑叶和深部脑微出血（CMB）。使用多变量逻辑回归评估 AMD 与 CAA 之间的关系，并根据 AMD 严重程度（无 AMD、早期 AMD 和晚期 AMD）进行比较。
我们的分析包括 256 对年龄匹配的患者（AMD 组 126 例，无 AMD 组 130 例）。其中 79 例（30.9%）为早期 AMD，47 例（19.4%）为晚期 AMD。平均年龄为 75±9 岁，两组间血管危险因素无显著差异。与无 AMD 组相比，AMD 患者的 CAA 患病率（16.7% vs. 10.0%，p=0.116）和表浅铁质沉着症（15.1% vs. 6.2%，p=0.020）更高，但深部 CMB 患病率（5.2% vs. 6.2%，p=0.426）无显著差异。调整协变量后，晚期 AMD 与 CAA（比值比 2.83，95%置信区间 1.10-7.27，p=0.031）和表浅铁质沉着症（比值比 3.40，95%置信区间 1.20-9.65，p=0.022）的患病风险增加相关，但与深部 CMB 无关（比值比 0.7，95%置信区间 0.14-3.51，p=0.669）。
AMD 与 CAA 和表浅铁质沉着症相关，但与深部 CMB 无关，这与淀粉样蛋白沉积在 AMD 发病机制中起作用的假说一致。需要前瞻性研究来确定 AMD 的特征是否可以作为 CAA 的早期诊断生物标志物。
