title: Age-Related Macular Degeneration and Incident Stroke: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  Age-related macular degeneration (AMD) is the leading cause of vision loss and blindness in people over 65 years old in the United States and has been associated with cardiovascular risk and decreased survival. There is conflicting data, however, regarding the contribution of AMD to the prediction of stroke.
  
  
  OBJECTIVE
  To determine whether AMD is a risk indicator for incident stroke in a meta-analysis of available prospective and retrospective cohort studies published in the English literature.
  
  
  METHODS
  We performed a systematic literature search of all studies published in English with Pub Med and other databases from 1966 to August 2014, reporting stroke incidence in patients with macular degeneration. Two investigators independently extracted the data. A random effects model was used to report Odds ratios (OR), with corresponding 95% confidence intervals (CI). Meta-regression using a mixed linear model was used to understand potential heterogeneity amongst studies.
  
  
  RESULTS
  We identified 9 studies that reported stroke incidence in patients with and without early AMD (N = 1,420,978). No significant association was found between early AMD with incident stroke. Combined, these 9 studies demonstrated random effects (OR, 1.12; CI, 0.86-1.47; I2 = 96%). Meta-regression on baseline covariates of age, sex, and year of publication did not significantly relate to heterogeneity.
  
  
  CONCLUSIONS
  We found no significant relationship between AMD and incident stroke. Further studies are needed to clarify other causes of decreased survival in patients with AMD.
authors.affiliation: Division of Cardiology, Hartford Hospital, Hartford, Connecticut, United States of America.|University of Connecticut, School of Medicine, Farmington, CT, United States of America.
authors.forename: Antonio B
authors.initials: AB
authors.lastname: Fernandez
authors.affiliation: Division of Cardiology, Hartford Hospital, Hartford, Connecticut, United States of America.|University of Connecticut, Department of Kinesiology, Storrs, CT, United States of America.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Panza
authors.affiliation: Frank H. Netter School of Medicine, Quinnipiac University, Hamden, CT, United States of America.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Cramer
authors.affiliation: St Luke's-Roosevelt Hospitals of the Mount Sinai Health System, New York, NY, United States of America.
authors.forename: Saurav
authors.initials: S
authors.lastname: Chatterjee
authors.affiliation: Department of Medicine, St. Vincent's Medical Center, Bridgeport, CT, United States of America.
authors.forename: Ramya
authors.initials: R
authors.lastname: Jayaraman
authors.affiliation: Medical Service, Providence VA Medical Center and Department of Medicine, Alpert Medical School of Brown University, Providence, RI, United States of America.
authors.forename: Wen-Chih
authors.initials: WC
authors.lastname: Wu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008268:Macular Degeneration / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D008297:Male; D016017:Odds Ratio; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis