Clinical risk factors for age-related macular degeneration: a systematic review and meta-analysis

BMC Ophthalmology

Research Article

Paul Mitchell¹  Usha Chakravarthy²  Astrid Fletcher³  Elisabeth Piault⁴  Christopher Evans⁴  Ronald Buggage⁵  Andreas Pleil⁶  Gergana Zlateva⁶  Tien Y Wong⁷ 

[1] Centre for Vision Research, Westmead Millennium Institute, University of Sydney, Sydney, Australia;Centre for Vision Science, Queen's University Belfast, Northern Ireland, UK;Dept of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK;Mapi Values, Boston, Massachusetts, USA;Novartis, East Hanover, New Jersey, USA;Pfizer Inc, New York, New York, USA;Singapore Eye Research Institute, National University of Singapore, Singapore;Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Australia;

关键词: Prospective Cohort Study;    Plasma Fibrinogen;    Geographic Atrophy;    Current Cigarette Smoking;    Blue Mountain;   

DOI  :  10.1186/1471-2415-10-31

 received in 2010-04-23, accepted in 2010-12-13,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundAge-related macular degeneration (AMD) is the leading cause of blindness in Western countries. Numerous risk factors have been reported but the evidence and strength of association is variable. We aimed to identify those risk factors with strong levels of evidence which could be easily assessed by physicians or ophthalmologists to implement preventive interventions or address current behaviours.MethodsA systematic review identified 18 prospective and cross-sectional studies and 6 case control studies involving 113,780 persons with 17,236 cases of late AMD that included an estimate of the association between late AMD and at least one of 16 pre-selected risk factors. Fixed-effects meta-analyses were conducted for each factor to combine odds ratio (OR) and/or relative risk (RR) outcomes across studies by study design. Overall raw point estimates of each risk factor and associated 95% confidence intervals (CI) were calculated.ResultsIncreasing age, current cigarette smoking, previous cataract surgery, and a family history of AMD showed strong and consistent associations with late AMD. Risk factors with moderate and consistent associations were higher body mass index, history of cardiovascular disease, hypertension, and higher plasma fibrinogen. Risk factors with weaker and inconsistent associations were gender, ethnicity, diabetes, iris colour, history of cerebrovascular disease, and serum total and HDL cholesterol and triglyceride levels.ConclusionsSmoking, previous cataract surgery and a family history of AMD are consistent risk factors for AMD. Cardiovascular risk factors are also associated with AMD. Knowledge of these risk factors that may be easily assessed by physicians and general ophthalmologists may assist in identification and appropriate referral of persons at risk of AMD.

【 授权许可】

CC BY   
© Chakravarthy et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.