scholarly journals Thyroid disease is associated with higher age-related macular degeneration risk: results from a meta-analysis of epidemiologic studies

2021 ◽  
Author(s):  
Ziming Xu ◽  
Mei Zhang ◽  
Qing Zhang ◽  
Tingjuan Xu ◽  
Liming Tao
Keyword(s):  
Macular Degeneration ◽  
Publication Bias ◽  
Thyroid Disease ◽  
Meta Analysis ◽  
Epidemiologic Studies ◽  
Age Related Macular Degeneration ◽  
Significant Heterogeneity ◽  
Age Related ◽  
Study Results ◽  
Thyroid Medication

Background: Although epidemiologic studies have suggested that thyroid disease may be a risk factor for age-related macular degeneration (AMD), this finding is still controversial. Objectives: The aim of this meta-analysis was to investigate whether an association exists between thyroid disease and medication and AMD in epidemiologic studies. Methods: We searched PubMed, EMBASE, and Google Scholar from their inception to March 2020 for cross-sectional, case-control and cohort studies that assessed thyroid function and AMD risk. Data from selected studies were extracted, and a meta-analysis was performed using fixed-effect or random-effect models. The statistical heterogeneity (I2) among studies and the possibility of publication bias were evaluated. If I2 > 50%, a significant heterogeneity existed among studies and a random effects model was used to calculate the pooled RR. Otherwise, a fixed-effects model was performed. Results: A total of 13 epidemiologic studies that consisted of 7 thyroid disease and 7 thyroid medication studies were included. Statistically significant heterogeneity was observed in the study results (I2 thyroid disease = 80.1%, I2 thyroid medication = 69.0%). A significant positive association was found between thyroid disease and AMD, with an overall relative risk (RR) of 1.25 (95% CI: 1.02, 1.54). However, there was no statistical association between thyroid medication and AMD risk (pooled RR 1.26 [95% CI 0.92-1.72]). Egger’s test indicated that there was no significant publication bias for thyroid disease (P=0.889) or thyroid medication (P = 0.226). Conclusions: Our findings indicate that thyroid disease is associated with higher AMD risk. Thyroid disease prevention strategies may have a significant effect on the prevention of AMD and warrant further evaluation.

scholarly journals The Relationship between Age-Related Macular Degeneration and Cardiovascular Disease: A Meta-Analysis

2021 ◽  
Author(s):  
Jungmin LEE ◽  
Heuy Sun SUH ◽  
In Cheol HWANG
Keyword(s):  
Cardiovascular Disease ◽  
Macular Degeneration ◽  
Publication Bias ◽  
Meta Analysis ◽  
Age Related Macular Degeneration ◽  
Cochrane Library ◽  
Age Related ◽  
Increased Risk ◽  
Clinical Benefits ◽  
The Relationship

Background: Age-related macular degeneration (AMD) and cardiovascular disease (CVD) share pathogenic mechanisms, and their lead-lag relationship remains unclear. We performed a meta-analysis of data from longitudinal studies to evaluate the interactive association between age-related macular degeneration (AMD) and cardiovascular disease (CVD). Methods: A literature search was performed in PubMed, Embase, and Cochrane Library up to Feb 2019. Estimates were pooled by study quality and type of AMD and CVD. Publication bias was assessed by Begg’s test. Results: We identified nine studies for the risk of AMD in CVD and ten studies for the risk of CVD in AMD. Overall, evidence for the risk of CVD in AMD patients was most robust. Both early and late AMD preceded CVD, but more solid significance existed in late AMD. Among the types of CVD, stroke was more tightly associated with AMD than coronary heart disease. Publication bias was not significant in either direction. Conclusion: AMD is a risk factor for CVD, which is primarily driven by the increased risk of stroke in patients with late AMD. Moreover, these results suggested that AMD treatment and screening for CVD in AMD patients may have unexplored clinical benefits.

scholarly journals Comparative efficacy and safety of different regimens of ranibizumab for neovascular age-related macular degeneration: a network meta-analysis of randomised controlled trials

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040906
Author(s):  
Xinyu Zhao ◽  
Lihui Meng ◽  
Youxin Chen
Keyword(s):  
Adverse Events ◽  
Macular Degeneration ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Age Related Macular Degeneration ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Efficacy And Safety ◽  
Age Related ◽  
Randomised Controlled

ObjectiveTo give a comprehensive efficacy and safety ranking of different therapeutic regimens of ranibizumab for neovascular age-related macular degeneration (nAMD).DesignA systematic review and network meta-analysis.MethodsThe PubMed, Embase, Cochrane Central Register of Controlled Trials, and other clinical trial registries were searched up to 1 October 2019 to identify related randomised controlled trials (RCT) of different regimens of ranibizumab for nAMD. The primary efficacy outcome was the changes of best-corrected visual acuity (BCVA) at 1 year, the primary safety outcome was the incidence of severe ocular adverse events. Secondary outcomes such as changes of central retinal thickness (CRT) were evaluated. We estimated the standardised mean difference (SMD), ORs, 95% CIs, the surface under the cumulative ranking curves and the mean ranks for each outcome using network meta-analyses with random effects by Stata 14.0.ResultsWe identified 26 RCTs involving 10 821 patients with nAMD randomly assigned to 21 different therapeutic regimens of ranibizumab or sham treatment. Ranibizumab 0.5 mg (treat and extend, T&E) is most effective in terms of changes of BCVA (letters, SMD=21.41, 95% CI 19.86 to 22.95) and three or more lines of BCVA improvement (OR=2.83, 95% CI 1.27 to 4.38). However, it could not significantly reduce retreatment times compared with monthly injection (SMD=−0.94, 95% CI −2.26 to 0.39). Ranibizumab 0.5 mg (3+pro re nata)+non-steroidal anti-inflammatory drugs (NSAIDs) is most effective in reducing CRT and port delivery system of ranibizumab (100 mg/mL) could reduce the number of retreatment most significantly. All regimes have no more risk of severe ocular complications (including vitreous haemorrhage, rhegmatogenous retinal detachment, endophthalmitis, retinal tear and retinal pigment epithelium tear) or cardiocerebral vascular complications.ConclusionsRanibizumab 0.5 mg (T&E) is most effective in improving the visual outcome. The administration of topical NSAIDs could achieve additional efficacy in CRT reduction and visual improvement. Both interventions had acceptable risks of adverse events.

scholarly journals The Association Between Complement Component 2/Complement Factor B Polymorphisms and Age-related Macular Degeneration: A HuGE Review and Meta-Analysis

2012 ◽  
Vol 176 (5) ◽  
pp. 361-372 ◽  
Author(s):  
Ammarin Thakkinstian ◽  
Mark McEvoy ◽  
Usha Chakravarthy ◽  
Subhabrata Chakrabarti ◽  
Gareth J. McKay ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Meta Analysis ◽  
Complement Component ◽  
Age Related Macular Degeneration ◽  
Complement Factor ◽  
Factor B ◽  
Complement Factor B ◽  
Age Related

scholarly journals Disease stability and extended dosing under anti-VEGF treatment of exudative age-related macular degeneration (AMD) — a meta-analysis

2021 ◽  
Author(s):  
Justus G. Garweg ◽  
Christin Gerhardt
Keyword(s):  
Macular Degeneration ◽  
Meta Analysis ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Pubmed Central ◽  
Age Related ◽  
Interval Extension ◽  
Second Year ◽  
Mean Differences

Abstract Purpose To assess disease stability (absence of intra- and/or subretinal fluid) and the portion of eyes being capable to extend their treatment interval to ≥ 12 weeks in exudative age-related macular degeneration (AMD). Methods A systematic literature search was performed in NCBI, PubMed, CENTRAL, and ClinicalTrials.gov to identify clinical studies reporting treatment outcomes for ranibizumab, aflibercept, and brolucizumab in exudative AMD under a treat-and-extend protocol and a follow-up of ≥ 12 months. Weighted mean differences and subgroup comparisons were used to integrate the different studies. Results This meta-analysis refers to 29 published series, including 27 independent samples and 5629 patients. In the pooled group, disease stability was reported in 62.9% and 56.0%, respectively, after 12 and 24 months of treatment, whereas treatment intervals were extended to ≥ 12 weeks in 37.7% and 42.6%, respectively. Ranibizumab, aflibercept, and brolucizumab differed regarding their potential to achieve disease stability (56.3%, 64.5%, and 71.5% after 12, and 50.0%, 52.7% and 75.7% after 24 months; p = < 0.001) and to allow an interval extension to ≥ 12 weeks (28.6%, 34.2%, and 53.3% after 12, and 34.2%, 47.7%, and 41.7% after 24 months; p = < 0.001). Conclusion The portion of eyes achieving disease stability regressed in the second year, whereas the portion of eyes under a ≥ 12-week interval increased. This discrepancy may reflect the challenges in balancing between under-treatment and a reduced treatment burden.

scholarly journals Lutein and zeaxanthin intake and the risk of age-related macular degeneration: a systematic review and meta-analysis

2011 ◽  
Vol 107 (3) ◽  
pp. 350-359 ◽  
Author(s):  
Le Ma ◽  
Hong-Liang Dou ◽  
Yi-Qun Wu ◽  
Yang-Mu Huang ◽  
Yu-Bei Huang ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Macular Degeneration ◽  
Data Extraction ◽  
Meta Analysis ◽  
Age Related Macular Degeneration ◽  
Inverse Association ◽  
Age Related ◽  
Search Data ◽  
The Relationship ◽  
Study Quality Assessment

Lutein and zeaxanthin are thought to decrease the incidence of age-related macular degeneration (AMD); however, findings have been inconsistent. We conducted a systematic literature review and meta-analysis to evaluate the relationship between dietary intake of lutein and zeaxanthin and AMD risk. Relevant studies were identified by searching five databases up to April 2010. Reference lists of articles were retrieved, and experts were contacted. Literature search, data extraction and study quality assessment were performed independently by two reviewers and results were pooled quantitatively using meta-analysis methods. The potential sources of heterogeneity and publication bias were also estimated. The search yielded six longitudinal cohort studies. The pooled relative risk (RR) for early AMD, comparing the highest with the lowest category of lutein and zeaxanthin intake, was 0·96 (95 % CI 0·78, 1·17). Dietary intake of these carotenoids was significantly related with a reduction in risk of late AMD (RR 0·74; 95 % CI 0·57, 0·97); and a statistically significant inverse association was observed between lutein and zeaxanthin intake and neovascular AMD risk (RR 0·68; 95 % CI 0·51, 0·92). The results were essentially consistent among subgroups stratified by participant characteristics. The findings of the present meta-analysis indicate that dietary lutein and zeaxanthin is not significantly associated with a reduced risk of early AMD, whereas an increase in the intake of these carotenoids may be protective against late AMD. However, additional studies are needed to confirm these relationships.

scholarly journals Systematic review and meta-analysis of the association between complementary factor H Y402H polymorphisms and age-related macular degeneration

2006 ◽  
Vol 15 (18) ◽  
pp. 2784-2790 ◽  
Author(s):  
Ammarin Thakkinstian ◽  
Pearline Han ◽  
Mark McEvoy ◽  
Wayne Smith ◽  
Josephine Hoh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Macular Degeneration ◽  
Meta Analysis ◽  
Factor H ◽  
Age Related Macular Degeneration ◽  
Complementary Factor ◽  
Age Related

scholarly journals Long-term Use of Aspirin and Age-related Macular Degeneration

2013 ◽  
Vol 06 (02) ◽  
pp. 144 ◽  
Author(s):  
William G Christen ◽  
Emily Y Chew ◽  
◽  
Keyword(s):  
Macular Degeneration ◽  
Observational Studies ◽  
Randomized Trials ◽  
Epidemiologic Studies ◽  
Age Related Macular Degeneration ◽  
Neovascular Amd ◽  
Age Related ◽  
The Us ◽  
Regular Aspirin

Recent findings from observational epidemiologic studies have raised concern about a possible adverse effect of regular aspirin use in age-related macular degeneration (AMD), and in particular neovascular AMD, which is the leading cause of severe irreversible blindness in the US. In this report, we consider these findings in light of the relative strengths and limitations of observational studies and randomized trials. While the findings are important and warrant further investigation, the inherent limitations of observation studies, most notably uncontrolled confounding, preclude an interpretation of causality. Alternatively, the most reliable evidence with which to evaluate the effects of regular aspirin use in AMD will derive from well-designed randomized trials of sufficient size and duration.

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