Incidence of Intermediate-stage Age-related Macular Degeneration in Patients With Acquired Immunodeficiency Syndrome

To evaluate the incidence of intermediate-stage age-related macular degeneration (AMD) in patients with acquired immunodeficiency syndrome (AIDS). Cohort study. Patients enrolled in the Longitudinal Study of the Ocular Complications of AIDS (LSOCA) underwent 5- and 10-year follow-up retinal photogra...

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Veröffentlicht in:American journal of ophthalmology Jg. 179; S. 151 - 158
Hauptverfasser: Jabs, Douglas A., Van Natta, Mark L., Pak, Jeong Won, Danis, Ronald P., Hunt, Peter W.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Elsevier Inc 01.07.2017
Elsevier Limited
Schlagworte:
Acquired immune deficiency syndrome
Acquired Immunodeficiency Syndrome - complications
Adult
AIDS
Cytomegalovirus
Disease Progression
Female
Follow-Up Studies
HIV
Human immunodeficiency virus
Humans
Macular degeneration
Macular Degeneration - diagnosis
Macular Degeneration - epidemiology
Macular Degeneration - etiology
Male
Ophthalmology
Prospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
United States - epidemiology
United States > US
Age-related Macular Degeneration
Acquired Immunodeficiency Syndrome
ISSN:0002-9394, 1879-1891, 1879-1891
Online-Zugang:Volltext
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Zusammenfassung:To evaluate the incidence of intermediate-stage age-related macular degeneration (AMD) in patients with acquired immunodeficiency syndrome (AIDS). Cohort study. Patients enrolled in the Longitudinal Study of the Ocular Complications of AIDS (LSOCA) underwent 5- and 10-year follow-up retinal photographs. Intermediate-stage AMD (AREDS stage 3) was determined from these photographs by graders at a centralized Reading Center, using the Age-Related Eye Disease Study-2 grading system. The incidence of AMD in LSOCA was compared with that in the Multi-Ethnic Study of Atherosclerosis (MESA), a Human Immunodeficiency Virus (HIV)-uninfected cohort, which used a similar photographic methodology. The incidence of AMD in LSOCA was 0.65/100 person-years (PY). In a multivariate analysis the only significant risk factor for AMD in LSOCA was smoking; the relative risk vs never-smokers was 3.4 for former smokers (95% confidence interval [CI] 1.3, 9.5; P = .02) and 3.3 for current smokers (95% CI 1.1, 9.7; P = .03). Compared with the MESA cohort, the race/ethnicity- and sex-adjusted risk of AMD in LSOCA was 1.75 (95% CI 1.16, 2.64; P = .008), despite the fact that the mean age of the MESA cohort was 17 years greater than the LSOCA cohort (61 ± 9 years vs 44 ± 8 years). Patients with AIDS have a 1.75-fold increased race- and sex-adjusted incidence of intermediate-stage AMD compared with that found in an HIV-uninfected cohort. This increased incidence is consistent with the increased incidence of other age-related diseases in antiretroviral-treated, immune-restored, HIV-infected persons when compared with HIV-uninfected persons.
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ISSN:0002-9394
1879-1891
1879-1891
DOI:10.1016/j.ajo.2017.05.004