Elevated C-reactive protein levels in patients with polypoidal choroidal vasculopathy and patients with neovascular age-related macular degeneration.
OBJECTIVE
To determine the relationship between systemic C-reactive protein (CRP) levels and polypoidal choroidal vasculopathy (PCV) and advanced neovascular age-related macular degeneration (AMD) in Japanese patients.


METHODS
Case-control study.


METHODS
Ninety-seven patients with PCV, 176 with advanced neovascular AMD, and 262 control subjects without any macular abnormality were studied.


METHODS
Color fundus photographs of the macular area were taken from both eyes in all subjects. Indocyanine green angiography and fluorescein angiography were performed for diagnosis. The CRP level was measured by a high-sensitivity assay using a latex aggregation immunoassay, and the levels in patients with PCV and neovascular AMD were compared with that in the control group using the Kruskal-Wallis test. Associations between CRP and PCV or neovascular AMD were compared using logistic regression analysis by computing the odds ratios (ORs) and 95% confidence intervals (CIs) after the study populations were divided into quartiles.


METHODS
The CRP levels in patients with PCV, patients with neovascular AMD, and control subjects. Standard univariate and multivariate analyses between groups.


RESULTS
Median CRP levels were significantly higher in cases with PCV (0.94 mg/l) or with advanced neovascular AMD (0.95 mg/l) than in control subjects (0.43 mg/l) (P<0.001 for Kruskal-Wallis test). After adjusting for baseline characteristics such as age, gender, smoking status, alcohol use, body mass index, history, and use of antiinflammatory drugs, the increase in risk was significant for the highest quartile of CRP for both PCV (OR, 3.53; 95% CI, 1.49-8.40) and neovascular AMD (OR, 4.08; 95% CI, 1.94-8.56), and for the third quartile of CRP for neovascular AMD (OR, 2.29; 95% CI, 1.07-4.91). The trends for an increase in risk of disease with increase in CRP were statistically significant for both PCV (P = 0.001) and neovascular AMD (P<0.001).


CONCLUSIONS
The significant associations between elevated serum CRP levels and PCV or neovascular AMD in the Japanese strongly suggest that inflammatory processes are involved in the pathogenesis of PCV and neovascular AMD.
Kikuchi
Masato
M
Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nakamura
Makoto
M
Ishikawa
Kohei
K
Suzuki
Toshimitsu
T
Nishihara
Hiroaki
H
Yamakoshi
Tomomi
T
Nishio
Kazuko
K
Taki
Kentaro
K
Niwa
Toshimitsu
T
Hamajima
Nobuyuki
N
Terasaki
Hiroko
H
D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism*; D002829:Choroid / Q000098:blood supply*; D015862:Choroid Diseases / Q000097:blood* / Q000175:diagnosis; D020256:Choroidal Neovascularization / Q000097:blood* / Q000175:diagnosis; D004396:Coloring Agents; D016001:Confidence Intervals; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D007841:Latex Fixation Tests; D008268:Macular Degeneration / Q000097:blood* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000097:blood* / Q000175:diagnosis; D011795:Surveys and Questionnaires
D004396:Coloring Agents; D002097:C-Reactive Protein; D007208:Indocyanine Green