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Article
December 1992

Risk Factors for Neovascular Age-Related Macular Degeneration

Author Affiliations

From the Biometry and Epidemiology Program, National Eye Institute, Bethesda, Md. A complete list of investigators in the Eye Disease Case-Control Study appears at the end of this article.

Arch Ophthalmol. 1992;110(12):1701-1708. doi:10.1001/archopht.1992.01080240041025
Abstract

• Neovascular age-related macular degeneration (AMD) is one of five retinal disorders studied in the Eye Disease CaseControl Study. Data were obtained from 421 patients with neovascular AMD and 615 controls on a broad array of possible risk factors through interviews, clinical examinations, and laboratory analyses of blood samples. Decreased risk of neovascular AMD was associated with higher levels of carotenoids in the serum samples, higher horizontal cup-to-disc ratios, and use of postmenopausal exogenous estrogens in women. Increased risk of neovascular AMD was associated with cigarette smoking, higher levels of serum cholesterol, and parity greater than zero. No support was found for sunlight exposure, serum zinc levels, or iris color as risk factors for this disease. Although no association was found with a history of cardiovascular disease itself, the associations with postmenopausal exogenous estrogen use, cigarette smoking, and serum cholesterol level are consistent with a hypothesis linking risk factors for cardiovascular disease with neovascular AMD. The association noted between serum carotenoid levels and neovascular AMD supports the hypothesis that higher levels of micronutrients with antioxidant capabilities may decrease the risk of AMD.

References
1.
Verhoeff FH, Grossman HP.  Pathogenesis of disciform degeneration of the macula . Arch Ophthalmol . 1937;18:561-585.Article
2.
Kornzweig AL.  Changes in the choriocapillaris associated with senile macular degeneration . Ann Ophthalmol . 1977;9:753-764.
3.
Young RW.  Pathophysiology of age-related macular degeneration . Surv Ophthalmol . 1987;31:291-306.Article
4.
Friedman E, Ivry M, Ebert E, Glynn R, Gragoudas E, Seddon J.  Increased scleral rigidity and age-related macular degeneration . Ophthalmology . 1989;96:104-108.Article
5.
Kahn HA, Leibowitz HM, Ganley JP, et al.  The Framingham Eye Study II: association of ophthalmic pathology with single variables previously measured in the Framingham Heart Study . Am J Epidemiol . 1977;106:33-41.
6.
Goldberg J, Flowerdew G, Smith E, Brody JA, Tso MOM.  Factors associated with age-related macular degeneration: an analysis of data from the First National Health and Nutrition Examination Survey . Am J Epidemiol . 1988;128:700-710.
7.
Hyman LG, Lilienfeld AM, Ferris FL III, Fine SL.  Senile macular degeneration: a casecontrol study . Am J Epidemiol . 1983;118:213-227.
8.
Ferris FL III, Fine SL, Hyman L.  Agerelated macular degeneration and blindness due to neovascular maculopathy . Arch Ophthalmol . 1984;102:1640-1642.Article
9.
Sperduto RD, Ferris FL III, Kurinij N.  Do we have a nutritional treatment for age-related cataract or macular degeneration? Arch Ophthalmol . 1990;108:1403-1405.Article
10.
Gunter EW, Turner WE, Neese JW, Bayse DD. Laboratory Methods Used by the Clinical Chemistry Division, Centers for Disease Control, for the Second Health and Nutrition Examination Survey (NHANES II) 1976-1980 . Atlanta, Ga: Centers for Disease Control; 1985:17-20.
11.
Roe JH, Kuether CA.  The determination of ascorbic acid in whole blood and urine through the 2,4-dinitrophenylhydrazine derivative of dehydroascorbic acid . J Biol Chem . 1943;147:399-407.
12.
Sowell AL, Huff DL, Gunter EW, Driskell WJ.  Identification of cis-carotenoids in human sera analyzed by reversed-phase high-performance liquid chromatography with diode array detection . J Chromatogr . 1988;431:424-430.Article
13.
Lewis SA, Hardison NW, Veillon C.  Comparison of isotope dilution mass spectrometry and graphite furnace atomic absorption spectrometry with Zeeman background correction for determination of plasma selenium . Anal Chem . 1986;58:1272-1273.Article
14.
Paschal DC, Kimberly MM.  Automated direct determination of selenium in serum by electrothermal atomic absorption spectroscopy . Atomic Spectrosc . 1986;7:75-78.
15.
DiPietro ES, Bashor MM, Stroud PE, et al.  Comparison of an inductively coupled plasmaatomic emission spectroscopy method for the determination of calcium, magnesium, sodium, potassium, copper and zinc with atomic absorption spectroscopy and flame photometry methods . Sci Total Environ . 1988;74:249-262.Article
16.
Hyman L, Schachat A, Ferris F, et al.  Classification of age-related macular degeneration . Invest Ophthalmol Vis Sci . 1988;29:120.
17.
Seddon JM, Sahagian CR, Glynn RJ, Sperduto RD, Gragoudas ES, and the Eye Disorders Case-Control Study Group.  Evaluation of an iris color classification system . Invest Ophthalmol Vis Sci . 1990;31:1592-1598.
18.
Klein BE, Klein R.  Cataracts and macular degeneration in older Americans . Arch Ophthalmol . 1982;100:571-573.Article
19.
Sperduto RD, Hiller R.  Systemic hypertension and age-related maculopathy in the Framingham Study . Arch Ophthalmol . 1986;104:216-219.Article
20.
Barrett-Connor E, Bush TL.  Estrogen and coronary heart disease in women . JAMA . 1991;265:1861-1867.Article
21.
Newsome DA, Swartz M, Leone NC, Elston RC, Miller E.  Oral zinc in macular degeneration . Arch Ophthalmol . 1988;106:192-198.Article
22.
Park YK, Kim I, Yetley EA.  Characteristics of vitamin and mineral supplement products in the United States . Am J Clin Nutr . 1991;54:750-759.
23.
Green WR, McDonnell PH, Yeo JH.  Pathologic features of senile macular degeneration . Ophthalmology . 1985;92:615-627.Article
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