Objective
To examine the association of vasodilator and antihypertensive medication use with
the incidence of age-related macular degeneration (AMD).
Design
Longitudinal population-based study.
Participants
Persons 43 to 86 years of age living in Beaver Dam, Wisconsin, from 1988 through 1990.
Methods
Examinations were performed every 5 years over a 20-year period. There were 9676 total
person-visits over the course of the study. Status of AMD was determined from grading
retinal photographs.
Main Outcome Measures
Incidence of AMD.
Results
The 5-year incidence of early AMD over the 20-year period was 8.4%; for late AMD,
it was 1.4%; for pure geographic atrophy (GA), it was 0.6%; for exudative AMD, it
was 0.9%; and for progression of AMD, it was 24.9%. While adjusting for age, gender,
and other factors, using a vasodilator (hazard ratio [HR], 1.72; 95% confidence interval
[CI], 1.25–2.38), particularly oral nitroglycerin (HR, 1.81; 95% CI, 1.14–2.90), was
associated with an increased risk of early AMD. Using an oral β-blocker was associated
with an increased hazard of incident exudative AMD (HR, 1.71; 95% CI, 1.04–2.82),
but not pure GA (HR, 0.51; 95% CI, 0.20–1.29) or progression of AMD (HR, 0.92; 95%
CI, 0.67–1.28) over the 20-year period.
Conclusions
Use of vasodilators is associated with a 72% increase in the hazard of incidence of
early AMD, and use of oral β-blockers is associated with a 71% increase in the hazard
of incident exudative AMD. If these findings are replicated, it may have implications
for care of older adults because vasodilators and oral β-blockers are drugs that are
used commonly by older persons.
Abbreviations and Acronyms:
AMD ( age-related macular degeneration), BDES ( Beaver Dam Eye Study), BMI ( body mass index), CI ( confidence interval), GA ( geographic atrophy), HR ( hazard ratio), IOP ( intraocular pressure), MABP ( mean arterial blood pressure), OR ( odds ratio), OPP ( ocular perfusion pressure), PP ( pulse pressure), RPE ( retinal pigment epithelial)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: April 29, 2014
Accepted:
March 4,
2014
Received in revised form:
February 28,
2014
Received:
October 24,
2013
Footnotes
Supplemental material is available at www.aaojournal.org.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
The content is solely the responsibility of the authors and does not necessarily reflect the official views of the National Eye Institute or the National Institutes of Health.
Supported by the National Institutes of Health , Bethesda, Maryland (grant no.: EY06594 (B.E.K.K., R.K.). The National Eye Institute provided funding for entire study, including collection and analyses of data. Additional support was provided by an unrestricted grant from Research to Prevent Blindness, Inc, New York, New York. Neither funding organization had any role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.
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© 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
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