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BMC Ophthalmology
Published in: BMC Ophthalmology 1/2010

Open Access 01-12-2010 | Research article

Clinical risk factors for age-related macular degeneration: a systematic review and meta-analysis

Authors: Usha Chakravarthy, Tien Y Wong, Astrid Fletcher, Elisabeth Piault, Christopher Evans, Gergana Zlateva, Ronald Buggage, Andreas Pleil, Paul Mitchell

Published in: BMC Ophthalmology | Issue 1/2010

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Abstract

Background

Age-related macular degeneration (AMD) is the leading cause of blindness in Western countries. Numerous risk factors have been reported but the evidence and strength of association is variable. We aimed to identify those risk factors with strong levels of evidence which could be easily assessed by physicians or ophthalmologists to implement preventive interventions or address current behaviours.

Methods

A systematic review identified 18 prospective and cross-sectional studies and 6 case control studies involving 113,780 persons with 17,236 cases of late AMD that included an estimate of the association between late AMD and at least one of 16 pre-selected risk factors. Fixed-effects meta-analyses were conducted for each factor to combine odds ratio (OR) and/or relative risk (RR) outcomes across studies by study design. Overall raw point estimates of each risk factor and associated 95% confidence intervals (CI) were calculated.

Results

Increasing age, current cigarette smoking, previous cataract surgery, and a family history of AMD showed strong and consistent associations with late AMD. Risk factors with moderate and consistent associations were higher body mass index, history of cardiovascular disease, hypertension, and higher plasma fibrinogen. Risk factors with weaker and inconsistent associations were gender, ethnicity, diabetes, iris colour, history of cerebrovascular disease, and serum total and HDL cholesterol and triglyceride levels.

Conclusions

Smoking, previous cataract surgery and a family history of AMD are consistent risk factors for AMD. Cardiovascular risk factors are also associated with AMD. Knowledge of these risk factors that may be easily assessed by physicians and general ophthalmologists may assist in identification and appropriate referral of persons at risk of AMD.
Appendix
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Metadata
Title
Clinical risk factors for age-related macular degeneration: a systematic review and meta-analysis
Authors
Usha Chakravarthy
Tien Y Wong
Astrid Fletcher
Elisabeth Piault
Christopher Evans
Gergana Zlateva
Ronald Buggage
Andreas Pleil
Paul Mitchell
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2010
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/1471-2415-10-31

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Glaucoma awareness among people attending ophthalmic outreach services in Southwestern Ethiopia

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A case-control study: occupational cooking and the risk of uveal melanoma