Review Article

Relation between Age-Related Macular Degeneration and Cardiovascular Events and Mortality: A Systematic Review and Meta-Analysis

Table 1

Characteristics of 20 prospective cohort studies of AMD and risk of cardiovascular disease outcomes included in this meta-analysis.

Study: first author, yearCountry cohort detailsParticipants, age (years)Early AMDlate AMDEligibility criteriaMean follow-up, yearsOutcomeAdjustment for covariatesStudy design

Borger et al. 2003 [14]The Rotterdam Study
(Netherlands)
6339, age >55477104Retinal photograph7Mortality
(medical records)
Age, gender, smoking, BMI, cholesterol level, atherosclerosis, hypertension, history of cardiovascular diseaseprospective
Buch et al. 2005 [15]The Copenhagen City Eye Study (Denmark)866, 60–8022831Retinal photograph14Mortality
(ICD8, ICD10)
Age, gender, smoking status, alcohol consumption, BMI, total cholesterol level, hypertension, cardiovascular disease, diabetes mellitus, any cataract, visual loss (20/40)prospective
Clemons et al. 2004 [16]AREDS4753, 55–812650957Fundus photograph6.5Mortality
(medical records)
Age, sex, race, education, smoking status, BMI, diabetes mellitus, angina, cancer, hypertensionprospective
Cugati et al. 2007 [17]BMES (Australian)3532, age > 4917772Retinal photograph10.7Mortality
(ICD9, ICD10)
Age, sex, BMI, hypertension diabetes mellitus, current smoking, and baseline history of angina, acute myocardial infarction, triglyceride level, fibrinogen level, educational level, walking disability, strokeprospective
Duan et al. 2007 [18]USA1445677,
mean 76 (7.8)
12669330885ICD-92MI
(ICD-9)
Age, gender, race, hypertension, and diabetesretrospective
Fernandez et al. 2012 [19]MESA (USA)6233, 45–8489327Retinal photograph5.4CHD and
CVD (medical records)
Age, sex, race, hypertension, cigarette smoking, site of enrollment, CRP, level of education and diabetes, BMI, serum total cholesterol, low-density lipoprotein cholesterolprospective
Fisher et al. 2015 [20]AGES (Israel)4910, 67–961064277Retinal photograph8.6Mortality
(ICD-9)
Age, genderprospective
Golan et al. 2011 [21]MHS (Israel)68217, age ≥
65
6546ICD-94.75MI
(ICD-9)
Age, genderretrospective
Hu et al. 2010
[22]
LHID (Taiwan)1254,
mean 62.7
0209ICD-95Stroke
(ICD-9)
Age, gender, monthly income, level of urbanization, the geographic region of the communityretrospective
Ikram et al. 2012 [23]ARICS (USA)12216
45–64
57615Retinal photograph13Stroke
(medical records)
Mean arterial blood pressure, antihypertensive medications, cell count fasting glucose, white blood, total cholesterol, HDL-cholesterol, triglyceride levels, BMI, atrial fibrillation, cigarette smoking, alcohol consumption status.prospective
Knudtson et al. 2006 [24]BDES (Australian)4747,
43–84
90979Retinal photograph13.2Mortality
(ICD-9, ICD-10)
Age, sex, proteinuria, history of cancer, BMI, BMI2, ratio of total to high-density lipoprotein cholesterol level, smoking, pulse rate, education, diabetes status, cardiovascular SBP disease history, sedentary lifestyleprospective
Liao et al. 2008
[25]
CMS (USA)1303186, ≥65.014064527193ICD-92Stroke
(ICD-9)
Age, gender, race, hypertension, diabetesretrospective
Nguyen-Khoa et al. 2008
[26]
USA27411,
50–95
07203ICD-93.5MI and CVD
(ICD-9)
Presence of angina, cardiac arrhythmia, Charlson score, congestive heart failure, diabetes, heart disease, history of acute MI,
history of CVA, hyperlipidemia, hypertension, other cerebrovascular diseases
retrospective
Pedula et al. 2015
[27]
SOF (USA)1202,
≥65
44146Retinal photograph9.5Mortality and CVD
(ICD-9)
Age, race, self-reported frailty, body mass index, Minimental State Examination score, walking speed, history of congestive heart failure, history of myocardial infarction, history of chronic obstructive pulmonary disease, history of thiazide diuretic useProspective
Sun et al. 2009
[28]
CHS (USA)1715, 69–9726824Retinal photograph6CHD and stroke
(medical records)
Age, gender, race, systolic and diastolic, blood pressure, hypertension status, fasting glucose, triglyceride, low-density lipoprotein cholesterol, cigarette smoking, pack-years of smoking, CRPprospective
Tan et al. 2008
[29]
BMES (Australian)2853, 49–9713051Retinal photograph11Mortality (ICD-9, ICD-10)Age, gender, hypertension, diabetes, smoking, BMI, serum lipids, fibrinogen, white cell countprospective
Wieberdink et al. 2011 [9]The Rotterdam Study (Netherlands)6207, 61.7–74.8216693Retinal photograph13.6Stroke
(medical records)
Age, sex, diabetes, systolic blood pressure, antihypertensive
medication, current smoking, total cholesterol, high-density lipoprotein cholesterol, carotid artery plaques, body mass index, alcohol intake and CRP, APOE, CFH
prospective
Wong et al. 2006 [8]ARICS (USA)10405, 49–7349810Retinal photograph8Stroke
(ICD-9, ICD-10)
Age, sex, ethnicity, site, systolic blood pressure, diabetes, antihypertensive medication use, cigarette smokingprospective
Wong et al. 2007 [7]ARICS (USA)11414, 49–7354015Retinal photograph8Mortality and CHD
(medical records)
Age, gender, race, and center, and then further for education, body mass index, systolic and diastolic BPs, diabetes status, total plasma cholesterol and HDL-cholesterol, triglyceride, glucose, pack-years of cigarette smoking, current alcohol consumptionprospective
Alexander et al. 2007 [6]USA62179, mean 80.5015771ICD-92MI and CVD (ICD-9)Age, race, gender, length of data within the databaseretrospective

AREDS: Age-Related Eye Disease Study; BMES: Blue Mountains Eye Study; MESA: Multiethnic Study of Atherosclerosis; AGES: Age, Gene/Environment Susceptibility Reykjavik Study; LHID: Longitudinal Health Insurance Database; ARICS: Atherosclerosis Risk in Communities Study; BDES: Beaver Dam Eye Study; CMS: Medicare and Medicaid Services; SOF: Study of Osteoporotic Fractures; CHS: Cardiovascular Health Study; BMI: body mass index.