28 Oct Age-Related Macular Degeneration: If One Eye Has It, The Other Eye More Likely To Develop It As Well
MedicalResearch.com Interview with:
Ronald Klein, MD, MPH, Professor
Department of Ophthalmology and Visual Sciences
University of Wisconsin School of Medicine and Public Health
Madison WI
Medical Research: What are the main findings of the study?
Dr. Klein: We found that more severe age-related macular degeneration (AMD) in 1 eye was associated with increased incidence of age-related macular degeneration [levels 1-2: hazard ratio [HR], 4.90 [95%CI, 4.26-5.63] and accelerated progression [levels 2-3: HR, 2.09 [95%CI, 1.42-3.06]; levels 3-4: HR, 2.38 [95%CI, 1.74-3.25] and incidence of late age-related macular degeneration [levels 4-5: HR, 2.46 [95%CI, 1.65-3.66] in its fellow eye. Less severe AMD in 1 eye was associated with less progression of AMD in its fellow eye. We estimated that 51% of participants who develop any age-related macular degeneration maintained age-related macular degeneration severity states within 1 step of each other between eyes and 90% of participants stay within 2 steps.
Medical Research: What was most surprising about the results?
Dr. Klein: There were no surprises. We had hypothesized these findings based on clinical observations of the symmetry of age-related macular degeneration. The use of the Markov Multistate model allowed us to quantitate these relations of age-related macular degeneration between eyes.
Medical Research: What should clinicians and patients take away from your report?
Dr. Klein: The new findings reported in our paper may be of help to clinicians who are discussing the prognosis of the better eye with their patients. For example, they may use the findings in our study to tell their patients with one eye involved with early age-related macular degeneration and the other free of it, that the findings from Beaver Dam Eye Study, a large epidemiological study with follow-up of participants over a 20 year period provided estimates that, over 5 years, the eye free of age-related macular degeneration is approximately 2 1/2 to 3 1/2 times as likely to develop incident age-related macular degeneration than if the fellow eye is also free of AMD. For example, a patient who was 50 years of age, the incidence of any age-related macular degeneration in that eye by 55 years of age was higher if AMD was present in the fellow eye (7% vs 2%). It also may have value in the context of a clinical trial setting, where it provides estimates of progression of the better (worse) eye that can be used for sample size calculation for trials of eye-specific interventions for participants with asymmetric age-related macular degeneration.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Klein: Would like to see replication of these findings in other studies especially those using different classification systems.
Citation:
Last Updated on October 28, 2014 by Marie Benz MD FAAD