Hogan Brady, Mehta Nihaal, Caldwell Anne Strong, Marin A Itzam, Gill Zafar S, Liske-Cervantes Andres, Mathias Marc T, Manoharan Niranjan, Palestine Alan G, Forest Talisa E de Carlo, Mandava Naresh, Lynch Anne M, Patnaik Jennifer L
University of Colorado School of Medicine, Aurora, CO, United States.
Department of Ophthalmology, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, United States.
Front Ophthalmol (Lausanne). 2025 Apr 14;5:1535791. doi: 10.3389/fopht.2025.1535791. eCollection 2025.
This study aims to determine whether systemic beta-blocker use over time influences the progression from intermediate to advanced age-related macular degeneration (AMD).
This prospective cohort study utilized data from the University of Colorado Age-Related Macular Degeneration Registry at the UCHealth Sue Anschutz-Rodgers Eye Center. Patients with intermediate AMD (iAMD) enrolled between October 2014 and November 2021. At enrollment, patient demographics and medication history were recorded. Beta-blocker use was assessed at enrollment and at each follow-up visit. Participants were asked to return annually for imaging, and images were classified as either intermediate AMD or conversion to advanced non-neovascular (NNV) AMD or neovascular (NV) AMD by two vitreoretinal specialists using multimodal imaging. Time to conversion was analyzed using Kaplan-Meier curves for each advanced AMD phenotype and for overall conversion, stratified by beta-blocker status. Progression from intermediate to advanced AMD (NNV or NV) was determined using multimodal imaging, including optical coherence tomography, color fundus photography, and fundus autofluorescence of the posterior pole.
A total of 292 patients were included in the study, with 22.6% using a systemic beta-blocker and 36.6% ( = 107) progressing from iAMD to advanced AMD in at least one eye. Patients on a beta-blocker at enrollment were more likely to convert to NV AMD (HR: 1.92 [95% CI: 1.04, 3.55], -value = 0.036), but this association was no longer significant after adjusting for age and treated hypertension. No significant differences were observed in conversion to advanced NNV or any advanced AMD between groups (all > 0.05).
In adjusted analyses, systemic beta-blocker use was not significantly associated with the risk of progression from iAMD to advanced NV or NNV AMD.
本研究旨在确定长期使用全身性β受体阻滞剂是否会影响中度年龄相关性黄斑变性（AMD）向晚期的进展。
这项前瞻性队列研究使用了科罗拉多大学安舒茨医学校区苏·安舒茨 - 罗杰斯眼科中心的年龄相关性黄斑变性登记处的数据。2014年10月至2021年11月期间纳入中度AMD（iAMD）患者。在入组时，记录患者的人口统计学和用药史。在入组时以及每次随访时评估β受体阻滞剂的使用情况。参与者被要求每年返回进行成像，由两名玻璃体视网膜专科医生使用多模态成像将图像分类为中度AMD或转变为晚期非新生血管（NNV）AMD或新生血管（NV）AMD。使用Kaplan - Meier曲线分析每种晚期AMD表型以及总体转变的转变时间，并按β受体阻滞剂状态进行分层。使用多模态成像（包括光学相干断层扫描、彩色眼底照相和后极部眼底自发荧光）确定从iAMD到晚期AMD（NNV或NV）的进展。
共有292名患者纳入研究，其中22.6%使用全身性β受体阻滞剂，36.6%（n = 107）至少一只眼睛从iAMD进展为晚期AMD。入组时使用β受体阻滞剂的患者更有可能转变为NV AMD（风险比：1.92 [95%置信区间：1.04，3.55]，P值 = 0.036），但在调整年龄和治疗的高血压后，这种关联不再显著。两组之间在转变为晚期NNV或任何晚期AMD方面未观察到显著差异（所有P > 0.05）。
在调整分析中，全身性β受体阻滞剂的使用与从iAMD进展为晚期NV或NNV AMD的风险无显著关联。
