Cickusic Alma, Pavljasevic Suzana, Jusufovic Vahid, Sefic-Kasumovic Sanja, Hasic Adisa Pilavdzic, Halilbasic Meliha
Clinic for Eye Diseases, University Clinical Centre Tuzla; Tuzla, Bosnia and Herzegovina.
Polyclinic for Eye Disease, Health Centre, Tuzla; Tuzla, Bosnia and Herzegovina.
Med Arch. 2025;79(1):47-51. doi: 10.5455/medarh.2025.79.47-51.
Age-related macular degeneration (ARMD) is a chronic, incurable, progressive, multifactorial, neurodegenerative disease, which is one of the leading causes of visual impairment, among individuals above 60 years of age in developed countries. Over the past decades, the role of inflammation and CRP in the pathogenesis of ARMD has been investigated.
The study aimed to investigate the association between inflammation or CRP levels in prediction the development or the progression of ARMD.
This retrospective-prospective, case-control study, was conducted at the Clinic for Eye Diseases, University Clinical Center Tuzla, from 2020. to 2024. Two group of participants were included in this study. The first group (n=100 patients) consisted of patients diagnosed with different stages of ARMD, and second, control group (n=100 patients) consisted of patients without ARMD. The study included subjects of both sexes, divided into three age categories (≤55; 56-66; ≥67 years). Detailed ocular and systemic evaluations were performed, including fundus examination and OCT angiography. A 5mL sample of venous blood was colected to determine serum CRP levels, for the both group of patients, using latex immunoassay method. Statistical analysis, including Student's t-test, Chi square test and posthoc (Turkey) tests, was conducted using SPSS 26 for Windows, with p<0,05 considered significant.
Out of 100 patients, 34 were having early, 18 intermediate and 48 were having advanced stages of ARMD. The mean serum CRP levels in the ARMD group (8.39±27.22mg/L) were significantly higher compared to the control group, (2.52±5.35mg/L), p=0,000. Also, serum CRP values by age category, between ARMD subjects and the control group, showed statistically significant differences in all age groups: ≤55 p=0.032; 56-66 p=0.019; ≥67 p=0.000. The mean serum CRP levels was 6.6±6.9 mg/L, 10±13.3 mg/L and 16±22.7 mg/L, in early, intermediate and advanced ARMD, respectively. Comparing these CRP values and different stages of ARMD, there were found statistically significant differences between the three stages. Furthermore, these results showed that mean CRP values increase with disease severity.
Based on the obtained results serum CRP levels are significant risk factor in predicting the development and the progression of ARMD. Also, these results emphasize the role of systemic inflammation in the development and progression of ARMD.
年龄相关性黄斑变性（ARMD）是一种慢性、不可治愈、进行性、多因素的神经退行性疾病，是发达国家60岁以上人群视力损害的主要原因之一。在过去几十年中，炎症和CRP在ARMD发病机制中的作用已得到研究。
本研究旨在探讨炎症或CRP水平与ARMD发生或进展之间的关联。
本回顾性-前瞻性病例对照研究于2020年至2024年在图兹拉大学临床中心眼科诊所进行。本研究纳入了两组参与者。第一组（n = 100例患者）由被诊断为不同阶段ARMD的患者组成，第二组为对照组（n = 100例患者），由无ARMD的患者组成。研究包括男女受试者，分为三个年龄类别（≤55岁；56 - 66岁；≥67岁）。进行了详细的眼部和全身评估，包括眼底检查和OCT血管造影。采集两组患者5mL静脉血样本，采用乳胶免疫测定法测定血清CRP水平。使用SPSS 26 for Windows进行统计分析，包括Student's t检验、卡方检验和事后（Turkey）检验，p < 0.05被认为具有统计学意义。
100例患者中，34例处于ARMD早期，18例处于中期，48例处于晚期。ARMD组的平均血清CRP水平（8.39±27.22mg/L）显著高于对照组（2.52±5.35mg/L），p = 0.000。此外，ARMD受试者与对照组之间按年龄类别划分的血清CRP值在所有年龄组中均显示出统计学显著差异：≤55岁，p = 0.032；56 - 66岁，p = 0.019；≥67岁，p = 0.000。在ARMD早期、中期和晚期，平均血清CRP水平分别为6.6±6.9mg/L、10±13.3mg/L和16±22.7mg/L。比较这些CRP值与ARMD的不同阶段，发现三个阶段之间存在统计学显著差异。此外，这些结果表明平均CRP值随疾病严重程度增加。
基于所得结果，血清CRP水平是预测ARMD发生和进展的重要危险因素。此外，这些结果强调了全身炎症在ARMD发生和进展中的作用。
