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

Published

Journal Article (Review)

BACKGROUND: Age-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. METHODS: A 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. RESULTS: Increasing 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. CONCLUSIONS: Smoking, 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.

Full Text

Duke Authors

Cited Authors

  • Chakravarthy, U; Wong, TY; Fletcher, A; Piault, E; Evans, C; Zlateva, G; Buggage, R; Pleil, A; Mitchell, P

Published Date

  • January 2010

Published In

Volume / Issue

  • 10 /

Start / End Page

  • 31 -

PubMed ID

  • 21144031

Pubmed Central ID

  • 21144031

Electronic International Standard Serial Number (EISSN)

  • 1471-2415

International Standard Serial Number (ISSN)

  • 1471-2415

Digital Object Identifier (DOI)

  • 10.1186/1471-2415-10-31

Language

  • eng