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

Author(s):  
Kai Wang ◽  
Ming-Ju Hsieh ◽  
Hsiang-Wen Chien ◽  
Chia-Yi Lee ◽  
Chao-Bin Yeh ◽  
...  

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.

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 ◽  
...  

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.


2021 ◽  
Author(s):  
Mehrdad Afarid ◽  
Hooman Rezaie ◽  
Behzad Khademi1 ◽  
Mohammad Nami

BACKGROUND This study aimed at profiling cognitive functions in patients with age-related macular degeneration (AMD). OBJECTIVE The aim of our study was to evaluate cognitive functions in patients diagnosed with AMD METHODS This cross-sectional investigation enrolled 45 patients with AMD and 45 age- and sex-matched controls. The overall cognitive performance in AMD sufferer versus control subjects was asses using the Persian version of the Addenbrooke’s Cognitive Examination battery (ACE-R). Subjects’ sleep quality was also evaluated using the Pittsburgh Sleep Quality Index (PSQI). The mean global assessment and subscale scores were statistically compared between groups. RESULTS The mean global scores for ACE-R in AMD and control groups (80.4±12.3 and 86 ± 9.6, respectively) were found to be statistically different (p=0.018). On the other hand there was no significant difference (p=0.793) between the AMD and control groups in terms of PSQI scores (9.7±2.8 and 9.8±2.8, respectively). CONCLUSIONS AMD patients seem to have cognitively underperformed in memory and verbal fluency domains compared to the control group. Evidence on cognitive impairments in patients with AMD may possibly herald neurocognitive insufficiencies and have common pathological mechanisms with dementias.


2018 ◽  
Vol 28 (1) ◽  
pp. 80-86
Author(s):  
Caner Kara ◽  
Pınar Ç. Özdal ◽  
Emrullah Beyazyıldız ◽  
Nurgül E. Özcan ◽  
Mehmet Y. Teke ◽  
...  

Purpose: To investigate the levels of circulating CD34+ stem cells in patients with neovascular type age-related macular degeneration (AMD) and its relation with clinical and optical coherence tomography (OCT) findings. Methods: The study consisted of 55 patients: 28 patients (18 male and 10 female) with neovascular type AMD as a study group and 27 patients (12 male and 15 female) scheduled for cataract surgery as a control group. The level of CD34+ stem cells was measured by flow cytometry. Demographic and clinical data were recorded. Results: The mean ages of patients in the study and control groups were 71 ± 8 and 68 ± 6 years, respectively. There was no statistically significant difference in terms of age, sex, or systemic disease association between study and control groups. However, smoking status was significantly higher in the study group (67.9% vs 37.0%; p = 0.02). Stem cell levels were significantly higher in the study group (1.5 ± 0.9 vs 0.5 ± 0.3; p<0.001), but there was no relation between stem cell levels and clinical and OCT findings. Conclusions: Increased circulating CD34+ stem cell levels were observed in patients with choroidal neovascular membrane associated with AMD, but no significant relation was found between cell levels and clinical and OCT findings.


2021 ◽  
Author(s):  
Amirsaeid Moloodi ◽  
Hooman Rezaie ◽  
Behzad Khademi ◽  
Mohammad Nami

Objective: This study aimed at profiling cognitive functions in patients with age-related macular degeneration (AMD).Method: This cross-sectional investigation enrolled 45 patients with AMD and 45 age- and sex-matched controls. The overall cognitive performance in AMD sufferer versus control subjects was asses using the Persian version of the Addenbrooke’s Cognitive Examination battery (ACE-R). Subjects’ sleep quality was also evaluated using the Pittsburgh Sleep Quality Index (PSQI). The mean global assessment and subscale scores were statistically compared between groups.Results: The mean global scores for ACE-R in AMD and control groups (80.4±12.3 and 86 ± 9.6, respectively) were found to be statistically different (p=0.018). On the other hand there was no significant difference (p=0.793) between the AMD and control groups in terms of PSQI scores (9.7±2.8 and 9.8±2.8, respectively). Conclusion: AMD patients seem to have cognitively underperformed in memory and verbal fluency domains compared to the control group. Evidence on cognitive impairments in patients with AMD may possibly herald neurocognitive insufficiencies and have common pathological mechanisms with dementias.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Siin Kim ◽  
Sang Jun Park ◽  
Seong Jun Byun ◽  
Kyu Hyung Park ◽  
Hae Sun Suh

Abstract Background The exudative age-related macular degeneration (AMD) causes considerable healthcare costs for patients and healthcare system, which are expected to grow as the population ages. The objective of this study was to assess the incremental economic burden of exudative AMD by comparing total healthcare costs between the exudative AMD group and non-AMD group to understand economic burden related to exudative AMD. Methods This retrospective cohort study used the National Health Insurance Service database including the entire Korean population. Exudative AMD group included individuals with at least one claim for ranibizumab and one claim using the registration code for exudative AMD (V201). Non-AMD group was defined as individuals without any claims regarding the diagnostic code of H35.3 or ranibizumab. The exudative AMD group and non-AMD group were matched using a propensity-score model. Incremental healthcare resource utilization and healthcare costs were measured during a one-year follow-up by employing econometric models: ordinary least squares (OLS) with log transformation and heteroscedastic retransformation; and generalized linear model (GLM) with a log link function and gamma distribution. Results A total of 7119 exudative AMD patients were matched to 7119 non-AMD patients. The number of outpatient visits was higher in the exudative AMD group (P-value < 0.0001), while the length of hospitalization was shorter in exudative AMD group (P-value < 0.0001). Exudative AMD patients had total costs 2.13 times (95%CI, 2.08–2.17) greater than non-AMD group using OLS, and total costs 4.06 times (95%CI, 3.82–4.31) greater than non-AMD group using GLM. Annual incremental total costs were estimated as $5519 (OLS) and $3699 (GLM). Conclusions Exudative AMD was associated with significantly increased healthcare costs compared to the non-AMD group. Attention is needed to manage the socioeconomic burden of exudative AMD.


2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Harun Çakmak ◽  
Tolga Kocatürk ◽  
Sema Oruç Dündar ◽  
Mehmet Dündar ◽  
Müjdat Karabulut

Purpose. To evaluate association between erectile dysfunction (ED) and neovascular age-related macular degeneration (AMD).Methods. 195 men enrolled in this cross-sectional study. 90 of them had neovascular AMD and 105 of them were healthy volunteers. The International Index of Erectile Function (IIEF) questionnaire’s erectile function (EF) domain was used to assess ED. The patients in the study and control groups were statistically compared according to visual acuity, EF score, and body mass index.Results. The mean ages were 62 (54.5–73) and 60 (54–68), in the neovascular AMD and control groups, respectively. The total EF scores were 9 (6–16) in neovascular AMD and 18 (9.5–27) in control group. The results of IIEF questionnaire on neovascular AMD patients revealed that 85 men (94.4%) had some degree of ED, whereas 68 men (64.8%) had some degree of ED on control group. Patients with neovascular AMD had a significantly higher incidence of ED than control patients (). There was a significant association between ED and neovascular AMD ().Conclusions. Our results suggested that neovascular AMD has a high association with ED.


2020 ◽  
Author(s):  
Mohsen Farvardin ◽  
Seyed esmaeil mousavi ◽  
Kamran Zare ◽  
Somaye Bazdar ◽  
Zahra Farvardin ◽  
...  

Abstract Background: Age-related macular degeneration (AMD) is regarded amongst as a common conditions resulting in visual impairment in elderly. Age and gender are unmodifiable risk factors for AMD, obesity, smoking, and hyperlipidemia are known to be modifiable culprits. This has remained controversial for hypertension and thyroid dysfunction. The present study attempted to investigate possible links between thyroid dysfunction and incidence of wet AMD.Methods: The present case-control study enrolled a total number of 90 patients with wet AMD and 90sex-, age-matched control subjects through a convenient sequential sampling method. Thyroid hormones were profiled in serum assay. Statistical measures were done to compare means between groups.Results: Our findings showed a significant difference in free T4 levels between the between wet AMD and control groups (p = 0.002), though this has not been the case for T3 and TSH l. In addition, there were no differences in serum lipid profile between groups. Although there found to be no significant difference in the past history of hypertension and hyperlipidemia between wet AMD and control groups, history of smoking was higher in controls) (p = 0.039).Conclusion: Based on our findings retinal examination and proper screening need to perhaps be a part of the overall health examination especially in elderly subjects with thyroid dysfunction. The clinical significance and related recommendations on the above need ti substantiated in future community-based research.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0251931
Author(s):  
Yan Xin ◽  
Kang Zefeng ◽  
Li Ling ◽  
Guan Ruijuan

Objective To investigate the association between the nuclear factor kappa B (NF-kB) gene polymorphism and age-related macular degeneration (AMD) in a high-altitude population. Methods Fifty-five patients with AMD and 57 control subjects were recruited from the Qinghai Provincial People’s Hospital, China. Genomic DNA was extracted from the blood sample of each participant. Four NF-kB polymorphisms (rs3774959, rs3774932, rs3774937, and rs230526) were genotyped using a MassARRAY system. The genotype and allele frequencies were compared between the case and control groups using the chi-squared test or Fisher’s exact test. Results There was no significant difference in sex, age, hypertension, diabetes, blood lipid level or smoking and drinking status between the AMD and control groups (P > 0.05). The genotype distributions of four NF-kB polymorphisms were in accordance with Hardy-Weinberg equilibrium in the control group (P > 0.05). The frequencies of genotype AA of rs3774932 and genotype CC of rs3774937 were nominally significantly higher in the AMD group than in the control group (P = 0.046 and 0.023, respectively), although these associations did not survive the Bonferroni correction (corrected P > 0.05). Genotype distributions of rs3774959 and rs230526 were not significantly different between the two groups (P = 0.08 and 0.16, respectively). No significant difference in the allele frequencies of the four polymorphisms was found between the AMD and control groups (P > 0.05). Conclusions Genotype AA of rs3774932 and genotype CC of rs3774937 in NF-kB might be risk factors for AMD.


2021 ◽  
Author(s):  
Karen M Wai ◽  
Tedi Begaj ◽  
Sachi Patil ◽  
Evan Chen ◽  
John B Miller ◽  
...  

Purpose: To examine the effect of medication sample use (ranibizumab or aflibercept) on future anti-vascular endothelial growth factor (VEGF) agent selection in neovascular age-related macular degeneration (nvAMD). Design: Retrospective cohort study. Methods: nvAMD patients who underwent an initial anti-VEGF injection with a sample medication were compared to nvAMD control patients who never received a medication sample. Charts from 2017 through 2020 were reviewed for data regarding demographics, anti-VEGF agent selection, and visual acuity outcomes for both groups. Anti-VEGF agent selection for the first four injections and at one year were examined in both the sample and control groups. Results: Adherence to the initial agent was high between first and subsequent injections (2nd, 3rd, 4th injection, and 1 year) in both sample (96.2%, 95.9%, 91.9%, 93.4%, respectively) and control groups (98.1%, 94.2%, 94.9%, 87.8%, respectively). Bevacizumab usage was significantly lower among eyes receiving samples relative to controls at the second (1.9% vs. 38.7%, p<0.001), third (3.1% vs. 41.3%, p<0.001), fourth injections (4.7% vs. 40.4%, p<0.001), and at 1 year (0% vs. 33.8%, p<0.001). Aflibercept usage was significantly higher in sample eyes relative to controls at the second (78.3% vs. 43.4%, p<0.001), third (76.3% vs. 41.5%, p<0.001), and fourth injections (76.7% vs. 43.4%, p<0.001), and at 1 year (77.0% vs. 52.7%, p<0.001). Conclusions: Eyes receiving a sample anti-VEGF agent (ranibizumab or aflibercept) for their initial injection were less likely to receive bevacizumab at future visits relative to eyes that did not receive an anti-VEGF sample, even after one year of treatment.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2047
Author(s):  
Bénédicte M. J. Merle ◽  
Audrey Cougnard-Grégoire ◽  
Jean-François Korobelnik ◽  
Wolfgang Schalch ◽  
Stéphane Etheve ◽  
...  

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.


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