Association of emphysema, gout, and inflammatory markers with long-term incidence of age-related maculopathy.
OBJECTIVE
To examine the relationship of 2 diseases associated with systemic inflammatory response, emphysema and gout, and selected markers of systemic inflammation with the 10-year incidence of age-related maculopathy.


METHODS
Population-based cohort study.


METHODS
We included persons aged 43 to 86 years at baseline examination from 1988 to 1990 living in Beaver Dam, Wis, of whom 3684 subjects participated in a 5-year follow-up examination and 2764 participated in a 10-year follow-up.


METHODS
Standardized protocols for physical examination, blood collection, administration of a questionnaire, and stereoscopic color fundus photography to determine the presence of age-related maculopathy. Standard univariate and multivariate analyses were performed.


METHODS
Incidence and progression of age-related maculopathy.


RESULTS
While controlling for age, sex, and other factors (history of heavy drinking or smoking, systolic blood pressure, and vitamin use), a higher white blood cell count at baseline was associated with the 10-year incidence of drusen 125 microm or greater in diameter (risk ratio [RR] per 10(6)/ microL = 1.10; 95% confidence interval [CI], 1.03-1.17), retinal pigment epithelial depigmentation (RR = 2.08; 95% CI, 1.01-1.16), and progression of age-related maculopathy (RR = 1.09; 95% CI, 1.03-1.15). A lower serum albumin level was associated with the incidence of exudative macular degeneration (RR per grams per deciliter = 0.31; 95% CI, 0.13-0.76). A history of emphysema at baseline was associated with the incidence of retinal pigment epithelial depigmentation (RR = 2.84; 95% CI, 1.40-5.78), increased retinal pigment (RR = 2.20; 95% CI, 1.11-4.35), and exudative macular degeneration (RR = 5.12; 95% CI, 1.63-16.06); a history of gout was associated with the incidence of pure geographic atrophy (RR = 3.48; 95% CI, 1.27-9.53).


CONCLUSIONS
These findings indicate modest relationships between both increased white blood cell count and emphysema and the increased 10-year incidence of lesions defining early and late age-related maculopathy. Further investigation of these relationships in other studies is needed.
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, 53726-2397, USA. kleinr@epi.ophth.wisc.edu
Ronald
R
Klein
Barbara E K
BE
Klein
Sandra C
SC
Tomany
Karen J
KJ
Cruickshanks
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis*; D015331:Cohort Studies; D005260:Female; D006073:Gout / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007958:Leukocyte Count; D008268:Macular Degeneration / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011656:Pulmonary Emphysema / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D015593:Retinal Drusen / Q000453:epidemiology; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D014922:Wisconsin / Q000453:epidemiology
D015415:Biomarkers; D012709:Serum Albumin