[Phototoxic drugs and age-related maculopathy].
OBJECTIVE
To disclose a correlation between age-related macular degeneration (AMD) and long-lasting treatments with potentially phototoxic drugs.


METHODS
Case-control study.


METHODS
The case group was made up of 90 randomized patients, 65 years old or older, with documented AMD, examined in 1998 and 1999. The M/F sex ratio was 0.54, and mean age 79.9 years. The control group was randomized with age- and sex-matched subjects. In both groups, we noted long-lasting oral treatment for hypertension, diabetes mellitus, epilepsy, hyperuricemia, and psychiatric pathologies. All the study group patients underwent a complete ophthalmological examination for visual acuity, contrast sensitivity, biomicroscopy, fundus color and red-free photographs, fluorescein and ICG angiographies.


RESULTS
When the study group was compared with the control group, neovascular AMD was positively associated with thiazide diuretics (p<0.001). When the study group was analyzed alone, intake of one or several antihypertensive drugs was positively associated with occult neovascularization and mild to moderate visual loss (p=0.009). Only thiazide diuretic intake was positively associated with severe bilateral loss of vision (p=0.041) and extensive choroidal neovascularization with major subretinal hemorrhages (p=0.022).


CONCLUSIONS
These findings suggest that severe neovascular AMD is associated with long-term thiazide diuretic treatment.
de La Marnierre
E
E
Clinique Ophtalmologique, HIA Legouest, 27, avenue de Plantières, BP 10, 57998 Metz-Armées.
Guigon
B
B
Quaranta
M
M
Mauget-Faÿsse
M
M
D000368:Aged; D000375:Aging; D001581:Benzothiadiazines; D015350:Contrast Sensitivity; D004232:Diuretics; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000209:etiology*; D008297:Male; D017319:Photosensitizing Agents / Q000009:adverse effects*; D012016:Reference Values; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects*; D014787:Vision Tests; D014792:Visual Acuity
D001581:Benzothiadiazines; D004232:Diuretics; D017319:Photosensitizing Agents; D049993:Sodium Chloride Symporter Inhibitors