322-OR: Delaying Progression of Diabetic Retinopathy Worsens the Risk for Age-Related Macular Degeneration
Abstract
Given the increasing prevalence of diabetes in the elderly, understanding factors that influence age-related macular degeneration (AMD) and diabetic retinopathy (DR) is crucial to target intervention for both. Previously, we found an inverse relationship between DR and AMD in the Joslin 50-Year Medalist Study composed of individuals who have had insulin-dependent diabetes for over 50 years. This study evaluated the relationship between AMD and DR in an age-matched cohort of people with type 1 diabetes from the Beetham Eye Institute (BEI) at Joslin Diabetes Center (N=1413) with the Medalist Study. The presence of AMD and DR severity were assessed from fundus photography. Advanced glycation endproducts (AGEs), specifically carboxymethyl-lysine, carboxyethyl-lysine, and methylglyoxal-derived hydroimidazolone 1, were quantified using high-performance liquid chromatography mass spectrometry and inflammatory cytokines by ELISA. We found an inverse association between DR severity and the presence of AMD in the BEI cohort (P<0.0001), consistent with previous findings in Medalists. The presence of AMD was associated with less frequent diabetic macular edema (7.6% vs 16.7%, P=0.01). In Medalists, there was no correlation of plasma inflammatory cytokines including interleukin-6 with DR, AMD, or their vitreous concentrations, whereas serum AGE levels were positively associated with DR severity, but inversely with AMD (P<0.05). Higher triglyceride/high-density lipoprotein ratio and lower…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,413 participants or records.
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