Pulmonary disease and age-related macular degeneration: the Beaver Dam Eye Study.
OBJECTIVE
To examine the association of pulmonary symptoms, disease, and function with the incidence of age-related macular degeneration (AMD).


METHODS
Population-based cohort study of persons aged 43 to 86 years at baseline (N = 4926), of whom 3779 participated in 1 or more follow-up examinations.


METHODS
Stereoscopic photographs of the macula were graded to determine the presence of AMD. Existence of emphysema, asthma, and respiratory symptoms was determined from subjects' medical history questionnaires; the peak expiratory flow rate was measured using a Mini-Wright Peak Flow Meter (Clement Clarke International, Harlow, England). Discrete logistic hazard and logistic regression models were used.


METHODS
Incidence and progression of AMD.


RESULTS
While controlling for age, sex, and other factors, a history of emphysema at baseline was found to be associated with the 15-year cumulative incidence of increased retinal pigment (odds ratio, 2.08; 95% confidence interval, 1.06-4.06), retinal pigment epithelium depigmentation (2.40; 1.23-4.67), and exudative AMD (3.65; 1.24-10.73). Mild pulmonary symptoms were associated with the 5-year incidence of exudative AMD (odds ratio, 3.83; 95% confidence interval, 1.39-10.58), and the fourth (ie, highest) quartile of pulmonary expiratory flow rate showed a protective effect for progression of AMD among women (0.36; 0.15-0.86).


CONCLUSIONS
Independent of smoking, a history of emphysema and respiratory symptoms and function are modestly but inconsistently associated with the incidence and progression of AMD.
Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726-2336, USA. kleinr@epi.ophth.wisc.edu
Ronald
R
Klein
Michael D
MD
Knudtson
Barbara E K
BE
Klein
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000150:complications; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008171:Lung Diseases / Q000150:complications* / Q000503:physiopathology; D008268:Macular Degeneration / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D010857:Pigment Epithelium of Eye / Q000378:metabolism; D011656:Pulmonary Emphysema / Q000150:complications; D012120:Respiration Disorders / Q000150:complications; D012168:Retinal Pigments / Q000378:metabolism; D012720:Severity of Illness Index; D012737:Sex Factors; D015854:Up-Regulation
D012168:Retinal Pigments