Risk of Stroke Connected With Macular Degeneration

Patients suffering from macular degeneration are at risk for both hemorrhagic and ischemic stroke, according to a report from MedPage Today.

Middle-aged individuals affected by macular degeneration had a higher rate of any type of stroke (7.6% as opposed to 4.9%) through a median follow-up of 13 years, says M. Kamran Ikram, M.D. of the Singapore Eye Research Institute.

As reported in Stroke: Journal of the American Heart Association, the difference for both ischemic stroke and intracerebral hemorrhage was consistent (6.4% versus 4.4%, and 1.2% versus 0.4%, respectively). Say the researchers behind the report, “These data provide further insight into common pathophysiological processes between age-related macular degeneration and stroke subtypes.”

The current study consisted of 12,216 middle-aged patients (ages 45 – 64) who had retinal photographs taken during the third examination visit from the Atherosclerosis Risk in Communities (ARIC) study.

Past studies have investigated the connection between age-related macular degeneration and stroke. Some studies have shown an existing relationship between the two, whereas the others indicated no correlation.

Of the participants, 591 (4.9%) had age-related macular degeneration. 576 of them had an early stage of the disease, i.e. the presence of either only soft drusen, retinal pigment epithelial depigmentation, or a combination of increased retinal epithelial and/or retinal pigment depigmentation with soft drusen.

The remaining participants had late disease, indicated by the presence of exudative age-related macular degeneration, or pure geographic atrophy. 619 of the participants (5.1%) had a stroke through follow-up. This included 548 cerebral infarctions, 57 intracerebral hemorrhages, and 14 subarachnoid hemorrhages.

Those patients with age-related macular degeneration were approximately 50% likelier to have a stroke during follow-up, after being adjusted for age, race, sex, mean arterial blood pressure, field center, fasting glucose, antihypertensive medications, HDL cholesterol, body mass index, triglyceride levels, white blood cell count, atrial fibrillation, smoking, and alcohol consumption.

The researchers pointed out a few of the study’s limitations, such as how the technique used for retinal photography makes grading age-related macular degeneration more variable. Other limits included the use of photos from only one eye of each participants, and the small number of patients with late age-related macular degeneration.

“Based on our findings, it appears that patients with [the eye disease] may already be at an increased risk of intracerebral hemorrhage and, thus, antivascular endothelial growth factor therapy could potentially increase this risk further,” say the authors of the report.

“However, additional studies are needed to confirm this potential side effect of antivascular endothelial growth factor agents.”

Source: http://www.medpagetoday.com/Cardiology/Strokes/32382


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