title: Patients with early age-related macular degeneration exhibit signs of macro- and micro-vascular disease and abnormal blood glutathione levels.
abstract: BACKGROUND
  This pilot study aimed to investigate systemic and retinal vascular function and their relationship to circulatory markers of cardiovascular risk in early age-related macular degeneration (AMD) patients without any already diagnosed systemic vascular pathologies.
  
  
  METHODS
  Fourteen patients diagnosed with early AMD and 14 age- and gender-matched healthy controls underwent blood pressure, carotid intima-media thickness (C-IMT) and peripheral arterial stiffness measurements. Retinal vascular reactivity was assessed by means of dynamic retinal vessel analysis (DVA) using a modified protocol. Blood analyses were conducted for glutathione levels and plasma levels of total cholesterol (CHOL), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG).
  
  
  RESULTS
  The AMD patients showed significantly greater C-IMT (p = 0.029) and augmentation index (AIx) (p = 0.042) than the age-matched controls. In addition, they demonstrated a shallower retinal arterial dilation slope (Slope AD) (p = 0.005) and a longer retinal venous reaction time (RT) to flickering light (p = 0.026). Blood analyses also revealed that AMD patients exhibited higher oxidized glutathione (GSSG) (p = 0.024), lower redox index (p = 0.043) and higher LDL-C (p = 0.033) levels than the controls. Venous RT parameter correlated positively with blood GSSG levels (r = 0.58, p = 0.038) in AMD subjects, but not in the controls (p > 0.05).
  
  
  CONCLUSIONS
  Patients diagnosed with early AMD exhibit signs of systemic and retinal vascular alterations that correlated with known risk markers for future cardiovascular morbidity.
authors.affiliation: Vascular Research Laboratory, Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Aston Triangle, Birmingham, B4 7ET, UK.
authors.forename: Lu
authors.initials: L
authors.lastname: Qin
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Mroczkowska
authors.forename: Aniko
authors.initials: A
authors.lastname: Ekart
authors.forename: Sunni R
authors.initials: SR
authors.lastname: Patel
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Gibson
authors.forename: Doina
authors.initials: D
authors.lastname: Gherghel
mesh_terms: D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis*; D059168:Carotid Intima-Media Thickness; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D005978:Glutathione / Q000097:blood*; D006801:Humans; D008268:Macular Degeneration / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D010865:Pilot Projects; D012164:Retinal Diseases / Q000175:diagnosis*; D012171:Retinal Vessels / Q000473:pathology*; D014280:Triglycerides / Q000097:blood; D059289:Vascular Stiffness
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D002784:Cholesterol; D005978:Glutathione