Diabetes, cardiovascular morbidity, and risk of age-related macular degeneration in a primary care population

Abstract

Purpose: Age-related macular degeneration (AMD) is the most common cause of legal blindness in Western patients over 65 years of age. We aimed to establish the incidence of AMD, and the association of diabetes, and cardiovascular and eye diseases with the risk of AMD, in a large cohort of primary care patients in the United Kingdom.

Methods: Using data from The Health Improvement Network database in the United Kingdom, all individuals with a first recorded diagnosis of AMD from 2004 to 2010 were identified (N = 10,516) and frequency-matched to 19,389 AMD-free individuals by age, sex, and calendar year of AMD occurrence. Logistic regression was used to examine comorbidities and risk factors for AMD.

Results: The incidence of AMD was 18.08 (95% confidence interval [CI], 17.74-18.43) per 10,000 person-years. A positive association with AMD was observed for smoking, a high frequency of primary care visits, and referrals. Diabetes and use of antidiabetic drugs were associated with an increased risk of AMD. Prevalence of cardiovascular diseases among AMD patients was slightly higher than in controls, with a small increased risk of AMD among patients with myocardial infarction, heart failure, or hyperlipidemia. Positive associations were observed between prior eye diseases and risk of AMD, in particular for chorioretinal disorders.

Conclusions: The incidence of AMD in the United Kingdom is in line with previously reported incidence rates from population-based studies. The study suggests an association between diabetes, prior eye diseases, cardiovascular comorbidities and AMD risk, and a link between AMD and higher healthcare utilization.

Keywords: age-related macular degeneration; cardiovascular; diabetes; healthcare use.