Epidemiology of age-related macular degeneration (AMD): associations with cardiovascular disease phenotypes and lipid factors

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Abstract

Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in adults over 50 years old. Genetic, epidemiological, and molecular studies are beginning to unravel the intricate mechanisms underlying this complex disease, which implicate the lipid-cholesterol pathway in the pathophysiology of disease development and progression. Many of the genetic and environmental risk factors associated with AMD are also associated with other complex degenerative diseases of advanced age, including cardiovascular disease (CVD). In this review, we present epidemiological findings associating AMD with a variety of lipid pathway genes, cardiovascular phenotypes, and relevant environmental exposures. Despite a number of studies showing significant associations between AMD and these lipid/cardiovascular factors, results have been mixed and as such the relationships among these factors and AMD remain controversial. It is imperative that researchers not only tease out the various contributions of such factors to AMD development but also the connections between AMD and CVD to develop optimal precision medical care for aging adults.

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Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis.

Wan Wong, Xinyi Su, Xiang Li … (2014)

Numerous population-based studies of age-related macular degeneration have been reported around the world, with the results of some studies suggesting racial or ethnic differences in disease prevalence. Integrating these resources to provide summarised data to establish worldwide prevalence and to project the number of people with age-related macular degeneration from 2020 to 2040 would be a useful guide for global strategies. We did a systematic literature review to identify all population-based studies of age-related macular degeneration published before May, 2013. Only studies using retinal photographs and standardised grading classifications (the Wisconsin age-related maculopathy grading system, the international classification for age-related macular degeneration, or the Rotterdam staging system) were included. Hierarchical Bayesian approaches were used to estimate the pooled prevalence, the 95% credible intervals (CrI), and to examine the difference in prevalence by ethnicity (European, African, Hispanic, Asian) and region (Africa, Asia, Europe, Latin America and the Caribbean, North America, and Oceania). UN World Population Prospects were used to project the number of people affected in 2014 and 2040. Bayes factor was calculated as a measure of statistical evidence, with a score above three indicating substantial evidence. Analysis of 129,664 individuals (aged 30-97 years), with 12,727 cases from 39 studies, showed the pooled prevalence (mapped to an age range of 45-85 years) of early, late, and any age-related macular degeneration to be 8.01% (95% CrI 3.98-15.49), 0.37% (0.18-0.77), and 8.69% (4.26-17.40), respectively. We found a higher prevalence of early and any age-related macular degeneration in Europeans than in Asians (early: 11.2% vs 6.8%, Bayes factor 3.9; any: 12.3% vs 7.4%, Bayes factor 4.3), and early, late, and any age-related macular degeneration to be more prevalent in Europeans than in Africans (early: 11.2% vs 7.1%, Bayes factor 12.2; late: 0.5% vs 0.3%, 3.7; any: 12.3% vs 7.5%, 31.3). There was no difference in prevalence between Asians and Africans (all Bayes factors <1). Europeans had a higher prevalence of geographic atrophy subtype (1.11%, 95% CrI 0.53-2.08) than Africans (0.14%, 0.04-0.45), Asians (0.21%, 0.04-0.87), and Hispanics (0.16%, 0.05-0.46). Between geographical regions, cases of early and any age-related macular degeneration were less prevalent in Asia than in Europe and North America (early: 6.3% vs 14.3% and 12.8% [Bayes factor 2.3 and 7.6]; any: 6.9% vs 18.3% and 14.3% [3.0 and 3.8]). No significant gender effect was noted in prevalence (Bayes factor <1.0). The projected number of people with age-related macular degeneration in 2020 is 196 million (95% CrI 140-261), increasing to 288 million in 2040 (205-399). These estimates indicate the substantial global burden of age-related macular degeneration. Summarised data provide information for understanding the effect of the condition and provide data towards designing eye-care strategies and health services around the world. National Medical Research Council, Singapore. Copyright © 2014 Wong et al. Open Access article distributed under the terms of CC BY-NC-ND. Published by .. All rights reserved.

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Progress and challenges in translating the biology of atherosclerosis.

Peter Libby, Paul Ridker, Goran Hansson (2011)

Atherosclerosis is a chronic disease of the arterial wall, and a leading cause of death and loss of productive life years worldwide. Research into the disease has led to many compelling hypotheses about the pathophysiology of atherosclerotic lesion formation and of complications such as myocardial infarction and stroke. Yet, despite these advances, we still lack definitive evidence to show that processes such as lipoprotein oxidation, inflammation and immunity have a crucial involvement in human atherosclerosis. Experimental atherosclerosis in animals furnishes an important research tool, but extrapolation to humans requires care. Understanding how to combine experimental and clinical science will provide further insight into atherosclerosis and could lead to new clinical applications.

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Global estimates of visual impairment: 2010.

Donatella Pascolini, Silvio Paolo Mariotti (2012)

From the most recent data the magnitude of visual impairment and its causes in 2010 have been estimated, globally and by WHO region. The definitions of visual impairment are the current definitions of presenting vision in the International Classification of Diseases version 10. A systematic review was conducted of published and unpublished surveys from 2000 to the present. For countries without data on visual impairment, estimates were based on newly developed imputation methods that took into account country economic status as proxy. Surveys from 39 countries satisfied the inclusion criteria for this study. Globally, the number of people of all ages visually impaired is estimated to be 285 million, of whom 39 million are blind, with uncertainties of 10-20%. People 50 years and older represent 65% and 82% of visually impaired and blind, respectively. The major causes of visual impairment are uncorrected refractive errors (43%) followed by cataract (33%); the first cause of blindness is cataract (51%). This study indicates that visual impairment in 2010 is a major health issue that is unequally distributed among the WHO regions; the preventable causes are as high as 80% of the total global burden.

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Author and article information

Contributors

Katie L. Pennington: katie.pennington@hsc.utah.edu

Margaret M. DeAngelis: margaret.deangelis@utah.edu

Journal

Journal ID (nlm-ta): Eye Vis (Lond)

Journal ID (iso-abbrev): Eye Vis (Lond)

Title: Eye and Vision

Publisher: BioMed Central (London )

ISSN (Electronic): 2326-0254

Publication date (Electronic): 22 December 2016

Publication date PMC-release: 22 December 2016

Publication date Collection: 2016

Volume: 3

Electronic Location Identifier: 34

Affiliations

Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, UT USA

Article

Publisher ID: 63

DOI: 10.1186/s40662-016-0063-5

PMC ID: 5178091

PubMed ID: 28032115

SO-VID: 0fd42dd2-4155-42b3-81d1-c9d21c178e21

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 17 June 2016

Date accepted : 24 November 2016

Funding

Funded by: FundRef http://dx.doi.org/http://dx.doi.org/10.13039/100000053, National Eye Institute;

Award ID: EY014800

Funded by: FundRef http://dx.doi.org/10.13039/100000053, National Eye Institute;

Award ID: EY024234

Award Recipient : Katie L. Pennington

Funded by: FundRef http://dx.doi.org/10.13039/100001818, Research to Prevent Blindness;

Funded by: FundRef http://dx.doi.org/10.13039/100006325, ARVO Foundation for Eye Research;

Funded by: The Skaggs Foundation for Research

Funded by: The Macular Degeneration Foundation

Funded by: Center of Aging

Funded by: The Carl Marshall Reeves and Mildred Almen Reeves Foundation, Inc.

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Keywords: atherosclerosis,hypertension,retina,statins,stroke,cholesterol,obesity,bmi,antioxidants,genetic association

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Keywords: atherosclerosis, hypertension, retina, statins, stroke, cholesterol, obesity, bmi, antioxidants, genetic association

Epidemiology of age-related macular degeneration (AMD): associations with cardiovascular disease phenotypes and lipid factors

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Most cited references 238

Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis.

Progress and challenges in translating the biology of atherosclerosis.

Global estimates of visual impairment: 2010.

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