Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Risk Factors for Choroidal Neovascularization in the Second Eye of Patients With Juxtafoveal or Subfoveal Choroidal Neovascularization Secondary to Age-Related Macular Degeneration

Risk Factors for Choroidal Neovascularization in the Second Eye of Patients With Juxtafoveal or... Abstract Objectives: To verify and quantify previously reported risk factors for development of choroidal neovascularization (CNV) in the fellow eye of patients with 1 eye affected with CNV secondary to age-related macular degeneration, to examine the value of characteristics of the pericentral macula in the quantification of risk for developing CNV, and to explore whether the presence of occult CNV in the first eye affects the development of CNV in the fellow eye. Design, Patients, and Setting: Follow-up study of fellow eyes of 670 patients enrolled in multicenter, randomized clinical trials of laser photocoagulation of juxtafoveal or subfoveal CNV. Main Outcome Measure: Development of CNV. Results: Three characteristics of the central macula of the fellow eye and 1 systemic factor were associated independently with an increased risk of developing CNV: the presence of 5 or more drusen (relative risk, 2.1; 95% confidence interval,1.3-3.5), focal hyperpigmentation (relative risk, 2.0; 95% confidence interval, 1.4-2.9), 1 or more large drusen (relative risk, 1.5; 95% condfidence interval 1.0-2.2), and definite systemic hypertension (relative risk, 1.7; 95% confidence interval, 1.2-2.4). Estimated 5-year incidence rates ranged from 7% for the subgroup with no risk factors to 87% for the subgroup with all 4 risk factors. Characteristics of the pericentral macula were not strongly associated with the development of CNV. The presence of occult CNV in the first eye affected had no influence on the development of CNV or on the type of CNV in the fellow eye. Conclusions: The prognosis of the fellow eye is affected strongly by characteristics of its central macula and by systemic hypertension. These factors should be considered when counseling patients with unilateral neovascular age-related macular degeneration and when targeting patients for preventive interventions. References 1. Vingerling JR, Klaver CCW, Hofman A, de Jong PTVM. Epidemiology of age-related maculopathy . Epidemiol Rev . 1995;17:347-360. 2. Kahn HA, Leibowitz HM, Ganley JP, et al. The Framingham Eye Study, II: association of ophthalmic pathology with single variables previously measured in the Framingham Heart Study . Am J Epidemiol . 1977;106:33-41. 3. Maltzman BA, Mulvihill MN, Greenbaum A. Senile macular degeneration and risk factors: a case-control study . Ann Ophthalmol . 1979;11:1197-1201. 4. Delaney WV Jr, Oates RP. Senile macular degeneration: preliminary study . Ann Ophthalmol . 1982;14:21-24. 5. Hyman LG, Lilienfeld AM, Ferris FL, Fine SL. Senile macular degeneration: a case-control study . Am J Epidemiol . 1983;118:213-227. 6. Sperduto RD, Hiller R. Systemic hypertension and age-related maculopathy in the Framingham study . Arch Ophthalmol . 1986;104:216-219.Crossref 7. Newsome DA, Swartz M, Leone NC, Elson RC, Miller E. Oral zinc in macular degeneration . Arch Ophthalmol . 1988;106:192-198.Crossref 8. Goldberg J, Flowerdew G, Smith E, Brody JA, Tso MOM. Factors associated with age-related macular degeneration: an analysis of data from the first National Health and Nutrition Examination Survey . Am J Epidemiol . 1988;128:700-710. 9. Klein R, Klein BEK, Linton KLP, DeMets DL. The Beaver Dam Eye Study: the relationship of age-related maculopathy to smoking . Am J Epidemiol . 1993;137:190-200. 10. Klein R, Klein BEK, Franke T. The relationship of cardiovascular disease and its risk factors to age-related maculopathy: the Beaver Dam Eye Study . Ophthalmology . 1993;100:406-414.Crossref 11. Gass JDM. Drusen and disciform macular detachment and degeneration . Arch Ophthalmol . 1973;90:206-217.Crossref 12. Teeters VW, Bird AC. The development of neovascularization in senile disciform macular degeneration . Am J Ophthalmol . 1973;76:1-18. 13. Chandra SR, Gragoudas ES, Friedman E, Van Buskirk EM, Klein ML. Natural history of disciform degeneration of the macula . Am J Ophthalmol . 1974;78:579-582. 14. Gregor Z, Bird AC, Chisholm IH. Senile disciform macular degeneration in the second eye . Br J Ophthalmol . 1977;61:141-147.Crossref 15. Gregor Z, Joffe L. Senile macular changes in the black African . Br J Ophthalmol . 1978;62:547-550.Crossref 16. Strahlman ER, Fine SL, Hillis A. The second eye of patients with senile macular degeneration . Arch Ophthalmol . 1983;101:1191-1193.Crossref 17. Bressler SB, Maguire MG, Bressler NM, Fine SL, Macular Photocoagulation Study Group. Relationship of drusen and abnormalities of the retinal pigment epithelium to the prognosis of neovascular macular degeneration . Arch Ophthalmol . 1990;108:1442-1447.Crossref 18. Eye Disease Case-Control Study Group. Risk factors for neovascular age-related macular degeneration . Arch Ophthalmol . 1992;110:1701-1708.Crossref 19. Eye Disease Case-Control Study Group. Antioxidant status and neovascular age-related macular degeneration . Arch Ophthalmol . 1993;111:104-109.Crossref 20. Seddon JM, Ajani UA, Sperduto RD, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration: Eye Disease Case-Control Study Group . JAMA . 1994;272:1413-1420.Crossref 21. Cruickshanks KJ, Klein R, Klein BEK. Sunlight and age-related macular degeneration: the Beaver Dam Eye Study . Arch Ophthalmol . 1993;111:514-518.Crossref 22. Holz FG, Wolfensberger TJ, Piguet B,. Bilateral macular drusen in age-related macular degeneration . Ophthalmology . 1994;101:1522-1528.Crossref 23. Macular Photocoagulation Study Group. Krypton laser photocoagulation for neovascular lesions of age-related macular degeneration: results of a randomized clinical trial . Arch Ophthalmol . 1990;108:816-824.Crossref 24. Macular Photocoagulation Study Group. Laser photocoagulation for juxtafoveal choroidal neovascularization: five-year results from randomized clinical trials . Arch Ophthalmol . 1994;112:500-509.Crossref 25. Macular Photocoagulation Study Group. Laser photocoagulation of subfoveal neovascular lesions in age-related macular degeneration: results of a randomized clinical trial . Arch Ophthalmol . 1991;109:1220-1231.Crossref 26. Macular Photocoagulation Study Group. Laser photocoagulation of subfoveal recurrent neovascular lesions of age-related macular degeneration: results of a randomized clinical trial . Arch Ophthalmol . 1991;109:1232-1241.Crossref 27. Macular Photocoagulation Study Group. Laser photocoagulation of subfoveal neovascular lesions of age-related macular degeneration: updated findings from two clinical trials . Arch Ophthalmol . 1993;111:1200-1209.Crossref 28. Macular Photocoagulation Study Group. Macular Photocoagulation Study Manual of Procedures . Springfield, Va: National Technical Information Service; 1990. NTIS Accession No. PB90-115536. 29. Macular Photocoagulation Study Group. Subfoveal neovascular lesions in age-related macular degeneration: guidelines for evaluation and treatment in the macular photocoagulation study . Arch Ophthalmol . 1991;109:1242-1257.Crossref 30. Bressler NM, Bressler SB, West SK, Fine SL, Taylor HR. The grading and prevalence of macular degeneration in Chesapeake Bay watermen . Arch Ophthalmol . 1989;107:847-852.Crossref 31. Klein R, Davis MD, Magli YL, Segal P, Klein BEK, Hubbard L. The Wisconsin age-related maculopathy grading system . Ophthalmology . 1991;98:1128-1134.Crossref 32. International ARM Epidemiological Study Group. An international classification and grading system for age-related maculopathy and age-related macular degeneration . Surv Ophthalmol . 1995;39:367-374.Crossref 33. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations . J Am Stat Assoc . 1958;53:457-481.Crossref 34. Mantel N. Evaluation of survival data and two new rank order statistics arising in its consideration . Cancer Chemother Rep 1966;50:163-170. 35. Cox DR. Regression models and life tables . J R Stat Soc B . 1972;2:187-220. 36. Macular Photocoagulation Study Group. Five-year follow-up of fellow eyes of patients with age-related macular degeneration and unilateral extrafoveal choroidal neovascularization . Arch Ophthalmol . 1993;111:1189-1199.Crossref 37. Macular Photocoagulation Study Group. Argon laser photocoagulation for senile macular degeneration: results of a randomized clinical trial . Arch Ophthalmol . 1982;100:912-918.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Risk Factors for Choroidal Neovascularization in the Second Eye of Patients With Juxtafoveal or Subfoveal Choroidal Neovascularization Secondary to Age-Related Macular Degeneration

Archives of Ophthalmology , Volume 115 (6) – Jun 1, 1997

Loading next page...
 
/lp/american-medical-association/risk-factors-for-choroidal-neovascularization-in-the-second-eye-of-FF0ESn3CwS
Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1997.01100150743009
Publisher site
See Article on Publisher Site

Abstract

Abstract Objectives: To verify and quantify previously reported risk factors for development of choroidal neovascularization (CNV) in the fellow eye of patients with 1 eye affected with CNV secondary to age-related macular degeneration, to examine the value of characteristics of the pericentral macula in the quantification of risk for developing CNV, and to explore whether the presence of occult CNV in the first eye affects the development of CNV in the fellow eye. Design, Patients, and Setting: Follow-up study of fellow eyes of 670 patients enrolled in multicenter, randomized clinical trials of laser photocoagulation of juxtafoveal or subfoveal CNV. Main Outcome Measure: Development of CNV. Results: Three characteristics of the central macula of the fellow eye and 1 systemic factor were associated independently with an increased risk of developing CNV: the presence of 5 or more drusen (relative risk, 2.1; 95% confidence interval,1.3-3.5), focal hyperpigmentation (relative risk, 2.0; 95% confidence interval, 1.4-2.9), 1 or more large drusen (relative risk, 1.5; 95% condfidence interval 1.0-2.2), and definite systemic hypertension (relative risk, 1.7; 95% confidence interval, 1.2-2.4). Estimated 5-year incidence rates ranged from 7% for the subgroup with no risk factors to 87% for the subgroup with all 4 risk factors. Characteristics of the pericentral macula were not strongly associated with the development of CNV. The presence of occult CNV in the first eye affected had no influence on the development of CNV or on the type of CNV in the fellow eye. Conclusions: The prognosis of the fellow eye is affected strongly by characteristics of its central macula and by systemic hypertension. These factors should be considered when counseling patients with unilateral neovascular age-related macular degeneration and when targeting patients for preventive interventions. References 1. Vingerling JR, Klaver CCW, Hofman A, de Jong PTVM. Epidemiology of age-related maculopathy . Epidemiol Rev . 1995;17:347-360. 2. Kahn HA, Leibowitz HM, Ganley JP, et al. The Framingham Eye Study, II: association of ophthalmic pathology with single variables previously measured in the Framingham Heart Study . Am J Epidemiol . 1977;106:33-41. 3. Maltzman BA, Mulvihill MN, Greenbaum A. Senile macular degeneration and risk factors: a case-control study . Ann Ophthalmol . 1979;11:1197-1201. 4. Delaney WV Jr, Oates RP. Senile macular degeneration: preliminary study . Ann Ophthalmol . 1982;14:21-24. 5. Hyman LG, Lilienfeld AM, Ferris FL, Fine SL. Senile macular degeneration: a case-control study . Am J Epidemiol . 1983;118:213-227. 6. Sperduto RD, Hiller R. Systemic hypertension and age-related maculopathy in the Framingham study . Arch Ophthalmol . 1986;104:216-219.Crossref 7. Newsome DA, Swartz M, Leone NC, Elson RC, Miller E. Oral zinc in macular degeneration . Arch Ophthalmol . 1988;106:192-198.Crossref 8. Goldberg J, Flowerdew G, Smith E, Brody JA, Tso MOM. Factors associated with age-related macular degeneration: an analysis of data from the first National Health and Nutrition Examination Survey . Am J Epidemiol . 1988;128:700-710. 9. Klein R, Klein BEK, Linton KLP, DeMets DL. The Beaver Dam Eye Study: the relationship of age-related maculopathy to smoking . Am J Epidemiol . 1993;137:190-200. 10. Klein R, Klein BEK, Franke T. The relationship of cardiovascular disease and its risk factors to age-related maculopathy: the Beaver Dam Eye Study . Ophthalmology . 1993;100:406-414.Crossref 11. Gass JDM. Drusen and disciform macular detachment and degeneration . Arch Ophthalmol . 1973;90:206-217.Crossref 12. Teeters VW, Bird AC. The development of neovascularization in senile disciform macular degeneration . Am J Ophthalmol . 1973;76:1-18. 13. Chandra SR, Gragoudas ES, Friedman E, Van Buskirk EM, Klein ML. Natural history of disciform degeneration of the macula . Am J Ophthalmol . 1974;78:579-582. 14. Gregor Z, Bird AC, Chisholm IH. Senile disciform macular degeneration in the second eye . Br J Ophthalmol . 1977;61:141-147.Crossref 15. Gregor Z, Joffe L. Senile macular changes in the black African . Br J Ophthalmol . 1978;62:547-550.Crossref 16. Strahlman ER, Fine SL, Hillis A. The second eye of patients with senile macular degeneration . Arch Ophthalmol . 1983;101:1191-1193.Crossref 17. Bressler SB, Maguire MG, Bressler NM, Fine SL, Macular Photocoagulation Study Group. Relationship of drusen and abnormalities of the retinal pigment epithelium to the prognosis of neovascular macular degeneration . Arch Ophthalmol . 1990;108:1442-1447.Crossref 18. Eye Disease Case-Control Study Group. Risk factors for neovascular age-related macular degeneration . Arch Ophthalmol . 1992;110:1701-1708.Crossref 19. Eye Disease Case-Control Study Group. Antioxidant status and neovascular age-related macular degeneration . Arch Ophthalmol . 1993;111:104-109.Crossref 20. Seddon JM, Ajani UA, Sperduto RD, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration: Eye Disease Case-Control Study Group . JAMA . 1994;272:1413-1420.Crossref 21. Cruickshanks KJ, Klein R, Klein BEK. Sunlight and age-related macular degeneration: the Beaver Dam Eye Study . Arch Ophthalmol . 1993;111:514-518.Crossref 22. Holz FG, Wolfensberger TJ, Piguet B,. Bilateral macular drusen in age-related macular degeneration . Ophthalmology . 1994;101:1522-1528.Crossref 23. Macular Photocoagulation Study Group. Krypton laser photocoagulation for neovascular lesions of age-related macular degeneration: results of a randomized clinical trial . Arch Ophthalmol . 1990;108:816-824.Crossref 24. Macular Photocoagulation Study Group. Laser photocoagulation for juxtafoveal choroidal neovascularization: five-year results from randomized clinical trials . Arch Ophthalmol . 1994;112:500-509.Crossref 25. Macular Photocoagulation Study Group. Laser photocoagulation of subfoveal neovascular lesions in age-related macular degeneration: results of a randomized clinical trial . Arch Ophthalmol . 1991;109:1220-1231.Crossref 26. Macular Photocoagulation Study Group. Laser photocoagulation of subfoveal recurrent neovascular lesions of age-related macular degeneration: results of a randomized clinical trial . Arch Ophthalmol . 1991;109:1232-1241.Crossref 27. Macular Photocoagulation Study Group. Laser photocoagulation of subfoveal neovascular lesions of age-related macular degeneration: updated findings from two clinical trials . Arch Ophthalmol . 1993;111:1200-1209.Crossref 28. Macular Photocoagulation Study Group. Macular Photocoagulation Study Manual of Procedures . Springfield, Va: National Technical Information Service; 1990. NTIS Accession No. PB90-115536. 29. Macular Photocoagulation Study Group. Subfoveal neovascular lesions in age-related macular degeneration: guidelines for evaluation and treatment in the macular photocoagulation study . Arch Ophthalmol . 1991;109:1242-1257.Crossref 30. Bressler NM, Bressler SB, West SK, Fine SL, Taylor HR. The grading and prevalence of macular degeneration in Chesapeake Bay watermen . Arch Ophthalmol . 1989;107:847-852.Crossref 31. Klein R, Davis MD, Magli YL, Segal P, Klein BEK, Hubbard L. The Wisconsin age-related maculopathy grading system . Ophthalmology . 1991;98:1128-1134.Crossref 32. International ARM Epidemiological Study Group. An international classification and grading system for age-related maculopathy and age-related macular degeneration . Surv Ophthalmol . 1995;39:367-374.Crossref 33. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations . J Am Stat Assoc . 1958;53:457-481.Crossref 34. Mantel N. Evaluation of survival data and two new rank order statistics arising in its consideration . Cancer Chemother Rep 1966;50:163-170. 35. Cox DR. Regression models and life tables . J R Stat Soc B . 1972;2:187-220. 36. Macular Photocoagulation Study Group. Five-year follow-up of fellow eyes of patients with age-related macular degeneration and unilateral extrafoveal choroidal neovascularization . Arch Ophthalmol . 1993;111:1189-1199.Crossref 37. Macular Photocoagulation Study Group. Argon laser photocoagulation for senile macular degeneration: results of a randomized clinical trial . Arch Ophthalmol . 1982;100:912-918.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Jun 1, 1997

References