title: Increased risk of Parkinson disease following a diagnosis of neovascular age-related macular degeneration: a retrospective cohort study.
abstract: OBJECTIVE
  To investigate the risk for Parkinson disease during a 3-year follow-up period after a diagnosis of neovascular age-related macular degeneration (AMD) using a nationwide population-based dataset in Taiwan.
  
  
  METHODS
  A retrospective matched-cohort study.
  
  
  METHODS
  We identified 877subjects with neovascular AMD as the study cohort and randomly selected 8770 subjects for a comparison cohort. Each subject was individually followed for a 3-year period to identify those who subsequently developed Parkinson disease. Stratified Cox proportional hazard regressions were performed as a means of comparing the 3-year risk of subsequent Parkinson disease between the study and comparison cohorts.
  
  
  RESULTS
  The incidence rate of Parkinson disease was 5.32 (95% confidence interval [CI]: 3.03-8.72) per 1000 person-years in patients with neovascular AMD and 2.09 (95% CI: 1.59-2.70) per 1000 person-years in comparison patients. The log-rank test indicated that subjects with neovascular AMD had a significantly lower 3-year Parkinson disease-free survival rate than comparison subjects (P < .001). After censoring cases in which patients died during the follow-up period and adjusting for monthly income, geographic region, hypertension, diabetes, hyperlipidemia, and coronary heart disease, the hazard ratio of Parkinson disease during the 3-year follow-up period for subjects with neovascular AMD was 2.57 (95% CI: 1.42-4.64) that of comparison subjects.
  
  
  CONCLUSIONS
  In this study, subjects with neovascular AMD were found to be at a significant risk of Parkinson disease during a 3-year follow-up period after their diagnosis among Taiwanese Chinese. Further study is needed to confirm our findings and explore the underlying pathomechanism.
authors: Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, Ban Ciao, Taipei, Taiwan; Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
authors: Shiu-Dong
authors: SD
authors: Chung
authors: Department of Ophthalmology, Taipei Medical University Hospital, Taipei, Taiwan.
authors: Jau-Der
authors: JD
authors: Ho
authors: Department of Ophthalmology, Shin Kong Wu-Ho-Su Memorial Hospital, Taipei, Taiwan; School of Medicine, Fu-Jen Catholic University, Hsingchuang, Taiwan.
authors: Chao-Chien
authors: CC
authors: Hu
authors: Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
authors: Herng-Ching
authors: HC
authors: Lin
authors: Department of Neurology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address: jjs2239@tmu.edu.tw.
authors: Jau-Jiuan
authors: JJ
authors: Sheu
mesh_terms: D000368:Aged; D044466:Asian People / Q000208:ethnology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D010300:Parkinson Disease / Q000208:ethnology* / Q000503:physiopathology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D057135:Wet Macular Degeneration / Q000175:diagnosis* / Q000208:ethnology* / Q000503:physiopathology