scholarly journals Association of metformin and development of dry age-related macular degeneration in a U.S. insurance claims database

2021 ◽  
pp. 112067212199728
Author(s):  
Emily A Eton ◽  
Thomas J Wubben ◽  
Cagri G Besirli ◽  
Peiying Hua ◽  
Brendan McGeehan ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Proportional Hazard ◽  
Insurance Claims ◽  
Claims Database ◽  
Cumulative Dosage ◽  
Cox Proportional Hazard ◽  
Age Related ◽  
Prior Use ◽  
Cox Proportional Hazard Regression

Purpose: To assess whether metformin is associated with dry age-related macular degeneration (dAMD) development. Methods: In this retrospective cohort study, patients enrolled in a nationwide U.S. medical insurance claims database from 2002 to 2016 were included if they had diabetes mellitus, were ⩾55 years old, and were enrolled for ⩾2 years without a prior AMD diagnosis. The primary exposure was metformin use analyzed as either active or prior use or cumulative metformin dosage over the study period. A time updating Cox proportional hazard regression was used to estimate the hazard ratio of dAMD incidence with metformin exposure. Results: Among 1,007,226 diabetic enrollees, 53.3% were female and 66.4% were white with a mean hemoglobin A1c of 6.8%. Of eligible enrollees, 166,115 (16.5%) were taking metformin at the index date. Over the study period, 29,818 (3.0%) participants developed dAMD. In the active versus prior use of metformin model, active use conferred an increased hazard of developing dAMD (HR, 1.08; 95% CI, 1.04–1.12) while prior use had a decreased hazard (HR, 0.95; 95% CI 0.92–0.98). The cumulative metformin dosage model showed a significant trend toward increased hazard of dAMD incidence with increasing cumulative dosage ( p < 0.001), with the lowest dosage quartile having decreased hazard of dAMD incidence (HR, 0.95; 95% CI, 0.91–0.99) and the highest having increased hazard (HR, 1.07; 95% CI, 1.01–1.13). Conclusions: Small, conflicting associations between metformin exposure and development of dAMD were observed depending on cumulative dosage and whether drug use was active, suggesting metformin did not substantially affect the development of dAMD.

scholarly journals Pigmentary abnormality without significant drusen as a risk factor for late age-related macular degeneration

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Junwon Lee ◽  
Hyun Goo Kang ◽  
Hae Rang Kim ◽  
Christopher Seungkyu Lee ◽  
Min Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Macular Degeneration ◽  
Significant Risk ◽  
Age Related Macular Degeneration ◽  
Fundus Photography ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Age Related ◽  
Hazard Ratios ◽  
Disc Area

AbstractWe investigated the incidence and risk factors of late age-related macular degeneration (AMD) in the fellow eye (FE) without significant drusen of patients with unilateral exudative macular neovascularization (MNV). In this retrospective study, 241 eligible patients who were followed-up for more than 3 years were enrolled. We analyzed the incidence and hazard ratios (HRs) of late AMD in the FE according to demographic and ophthalmologic variables. Hypopigmentation on color fundus photography (CFP) corresponds to shallow irregular RPE elevation (SIRE), so-called “double-layer sign” and/or “attenuation or disruption of RPE and/or ellipsoid zone” on OCT. The 5-year incidence of FE exudative MNV conversion was 8.6%. The 5-year incidence of FE exudative MNV of large hypopigmentation (≥ 0.5 disc area; DA) and small hypopigmentation (< 0.5 DA) on CFP, and SIRE (≥ 1000 µm) and small RPE elevation (< 1000 µm) on OCT were 36.2%, 14.2%, 55.0%, and 15.6%, respectively. The multivariate Cox proportional hazard model revealed that large hypopigmentation, small hypopigmentation, SIRE, and small RPE elevation showed HRs of 23.230, 8.037, 132.589, and 41.823 for FE exudative MNV occurrence, respectively. Hypopigmentation on CFP and SIRE on OCT could represent the same lesion. Even small hypopigmentation and small RPE elevation were significant risk factors for progression to exudative MNV.

Traffic-related air pollutants increase the risk for age-related macular degeneration

2019 ◽  
Vol 67 (7) ◽  
pp. 1076-1081 ◽  
Author(s):  
Kuang-Hsi Chang ◽  
Po-Yuan Hsu ◽  
Chun-Ju Lin ◽  
Cheng-Li Lin ◽  
Suh-Hang Hank Juo ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Population Based ◽  
Air Pollutant ◽  
Age Related Macular Degeneration ◽  
Cox Proportional Hazard ◽  
Age Related ◽  
Increased Risk ◽  
Taiwan National Health Insurance ◽  
Cox Proportional Hazard Regression ◽  
Year 2000

The aim of this study was to investigate whether ambient nitrogen dioxide (NO2) and carbon monoxide (CO) increase the risk for age-related macular degeneration (AMD). This is a longitudinal population-based study using the data on Taiwan National Health Insurance Program between year 2000 and 2010. From the nationwide dataset, we enrolled subjects aged 50 or older and the annually total NO2 and CO exposure was calculated from 1998 to 2010 for each subject. The Cox proportional hazard regression was used to estimate the HRs with adjustment for other variables. A total of 39,819 AMD-free residents were enrolled, and 1442 participants developed AMD during the 11 -year follow-up. Compared with the lowest exposure quartile, the highest quartile of each air pollutant was associated with an increased risk for AMD. The adjusted HR was 1.91 (95% CI 1.64 to 2.23, p<0.001) for the highest NO2 quartile, and was 1.84 (95% CI 1.5 to 2.15, p<0.001) for the highest CO quartile. In this study, chronic exposure to the highest quartile of ambient NO2 or CO significantly increases the risk for AMD.

scholarly journals Plasma Lutein, a Nutritional Biomarker for Development of Advanced Age-Related Macular Degeneration: The Alienor Study

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2047
Author(s):  
Bénédicte M. J. Merle ◽  
Audrey Cougnard-Grégoire ◽  
Jean-François Korobelnik ◽  
Wolfgang Schalch ◽  
Stéphane Etheve ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
High Performance ◽  
Population Based ◽  
Age Related Macular Degeneration ◽  
Cox Proportional Hazard ◽  
Age Related ◽  
Cox Proportional Hazard Models ◽  
Adjusted Model ◽  
Reduced Risk

Lutein and zeaxanthin may lower the risk of age-related macular degeneration (AMD). We evaluated the associations of plasma lutein and zeaxanthin with the incidence of advanced AMD in the Alienor study (Antioxydants Lipides Essentiels Nutrition et Maladies Oculaires). Alienor study is a prospective population-based cohort of 963 residents of Bordeaux, France, who were 73 years or older at baseline (2006–2008). The present study included 609 participants with complete ophthalmologic and plasma carotenoids data. Examinations were performed every two years over an eight-year period (2006 to 2017). Plasma lutein and zeaxanthin were determined at baseline from fasting blood samples using high-performance liquid chromatography. Cox proportional hazard models were used to assess associations between plasma lutein, zeaxanthin, and their (total cholesterol (TC) + triglycerides (TG)) ratios with AMD. Among the 609 included participants, 54 developed advanced incident AMD during a median follow-up time of 7.6 years (range 0.7 to 10.4). Participants with higher plasma lutein had a reduced risk for incident advanced AMD in the fully adjusted model (HR = 0.63 per 1-SD increase (95% CI, 0.41–0.97), p = 0.03). A similar association was observed using the lutein/(TC + TG) ratio (HR = 0.59 (95% CI, 0.39–0.90), p = 0.01). No associations were evidenced for other carotenoids. Higher plasma lutein was associated with a 37% reduced risk of incident advanced AMD.

scholarly journals Medical Compliance of Fibrate and the Decreased Risk of Age-Related Macular Degeneration in Dyslipidemia-Related Diseases: A Population-Based Cohort Study

2021 ◽  
Vol 18 (1) ◽  
pp. 301
Author(s):  
Kai Wang ◽  
Ming-Ju Hsieh ◽  
Hsiang-Wen Chien ◽  
Chia-Yi Lee ◽  
Chao-Bin Yeh ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Population Based ◽  
Age Related Macular Degeneration ◽  
Diagnostic Code ◽  
Control Groups ◽  
Age Related ◽  
Dry Amd ◽  
Medical Compliance ◽  
Cox Proportional Hazard Regression ◽  
And Control

The purpose of the current study is to evaluate the incidence of age-related macular degeneration (AMD) in dyslipidemia-related diseases with or without the use of fibrate. Patients were defined as dyslipidemia-related diseases according to the diagnostic code and lab exam arrangement, then the population was divided into those with fibrate application and those without via 1:2 ratios of propensity-score matching. The primary outcome is the development of AMD after dyslipidemia-related diseases by the Cox proportional hazard regression. Besides, the relationship between the medical compliance of fibrate, presented as medical possession ratio (MPR), and the AMD development was also analyzed. A total of 22,917 patients and 45,834 individuals were enrolled in the study and control groups. There were 572 and 1181 events of any AMD development in the study and control groups which showed identical risk of AMD (aHR: 0.94, 95% CI: 0.85–1.04). However, a reduced risk of any AMD was found in those patients reached a baseline MPR more than 20% (aHR: 0.729, 95% CI: 0.599–0.887, p = 0.0016) and overall MPR more than 5% three years after the diagnosis of dyslipidemia-related diseases (aHR: 0.712, 95% CI: 0.557–0.909, p = 0.0065). Besides, a lower risk of dry-AMD was also found in those patients with the above conditions (aHR: 0.736, 95% CI: 0.599–0.906, p = 0.0038 and aHR: 0.721, 95% CI: 0.557–0.934, p = 0.0133, respectively). In conclusion, the use of fibrate with fair initial medical compliance will decrease the incidence of AMD in patients with dyslipidemia-related diseases, especially for the development of dry-AMD.

Age related macular degeneration (ARMD) – pathophysiological and clinical features and therapeutic concepts

2001 ◽  
Vol 58 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Ursula Körner-Stiefbold
Keyword(s):  
Macular Degeneration ◽  
Clinical Features ◽  
Altersbedingte Makuladegeneration ◽  
Age Related Macular Degeneration ◽  
Genetische Faktoren ◽  
Age Related ◽  
Therapeutic Concepts

Die altersbedingte Makuladegeneration (AMD) ist eine der häufigsten Ursachen für einen irreversiblen Visusverlust bei Patienten über 65 Jahre. Nahezu 30% der über 75-Jährigen sind von einer AMD betroffen. Trotz neuer Erkenntnisse in der Grundlagenforschung ist die Ätiologie, zu der auch genetische Faktoren gehören, noch nicht völlig geklärt. Aus diesem Grund sind die Behandlungsmöglichkeiten zum jetzigen Zeitpunkt noch limitiert, so dass man lediglich von Therapieansätzen sprechen kann. Die derzeit zur Verfügung stehenden Möglichkeiten wie medikamentöse, chirurgische und laser- und strahlentherapeutische Maßnahmen werden beschrieben.

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