Summary: People with age-related macular degeneration (subretinal drusenoid deposits) (SDD) have a higher risk of developing heart damage due to heart failure or other cardiovascular diseases and stroke risk factors.
Source: Mount Sinai Hospital
Patients with certain age-related macular degeneration (AMD), the leading cause of blindness in the United States, may have heart failure and heart failure or heart damage due to advanced heart valve disease or carotid artery disease. Arterial disease is linked to certain types of stroke, according to a new study from the Mount Sinai Division of Eye and Ear Disease in New York.
This study was published on November 17 BMJ Open OphthalmologyIt is the first to identify which cardiovascular and carotid artery diseases are associated with eye disorders.
The findings could prompt further testing to save vision, detect undiagnosed heart disease and prevent cardiovascular complications.
“For the first time, we have been able to link these specific high-risk cardiovascular diseases to a specific type of AMD, namely subretinal drusenoid deposits (SDDs),” said lead author R. Theodore Smith, MD, Ph.D. Professor of Ophthalmology at the Icahn School of Medicine at Mount Sinai.
“This study is the first strong link between the leading cause of blindness worldwide, AMD, and heart disease. We also have strong evidence for what happens: these diseases directly reduce the blood supply to the eye, heart damage causes blood loss throughout the body.” It reduces the supply, or directly obstructs the flow of blood through the blocked carotid artery.
Poor blood supply can damage any part of the body, and in these particular diseases, damaged retinas and residual SDDs are affected. Retinal damage means loss of vision and can lead to blindness.
ADHD is the leading cause of vision impairment and blindness in people over 65 years of age, and is damage to the central area of the macula retina, which is responsible for driving the ability to read and see.
Early forms of AD consist of small yellow cholesterol deposits called drusen, which form under a layer of the retina called the retinal pigment epithelium (RPE). The retina can be deprived of blood and oxygen, which leads to loss of vision. Drug addiction can be delayed with proper vitamin supplementation.
Another major early AD, subretinal drusenoid deposits (SDDs), is less common and requires high-tech retinal imaging to detect. These deposits contain a different type of cholesterol and form above the RPE and just below the light-sensitive retinal cells, where the damage occurs and vision is lost. There is no known cure for SDDs.
Dr. Smith and the team of Mount Sinai researchers found that patients with early cardiovascular disease or stroke are more likely to develop SDDs. The study, the first of its kind, was published in the July issue of Retina.
This new study expands on previous work by looking at a larger patient population and identifying specific types of heart disease and carotid artery disease that cause AMD SDDs.
Researchers analyzed retinal images of 200 AMD patients’ eyes to determine which SDDs were present. Patients answered a questionnaire about their cardiovascular disease history. Out of 200 patients, 97 were SDDs and 103 were drug addicts.
Of the 200, 47 had severe heart disease (19 from heart failure or heart failure, 17 from severe valvular disease, and 11 from carotid artery stroke).
47 of them (86 percent) had SDDs. In contrast, among 153 AD patients without these comorbidities, 57 had SDDs (43 percent).
The researchers found that these patients with severe cardiovascular disease and stroke were more likely to have ADHD. They pointed out that they are 9 times more likely to develop STDs than people without the disease.
“This work shows that ophthalmologists can be the first physicians to identify systemic disease, especially in asymptomatic patients,” said co-investigator Richard B.
“Identification of SDDs in the retina should be directed to the individual’s primary care provider, especially if no cardiologist has been involved before. Prevents a life-threatening cardiac event.
“This study opens the door to more fruitful multidisciplinary collaboration between ophthalmology, cardiology and neurology services,” said Jagat Narula, MD, PhD, director of the Cardiovascular Imaging Program at Xena and the Michael A. Wiener Cardiovascular Institute at the Icahn School of Medicine at Mount Sinai.
“Furthermore, we need to focus on vascular imaging in heart and neurology clinics to determine the severity of the disease and evaluate their impact on retinal imaging in AMD and SDDs. This way we can know which vascular patients should be referred for detection and prevention of blinding diseases.”
So vision and cardiovascular disease research news
Preliminary study: Open Access.
“Subretinal drusenoid deposits are strongly associated with high-risk coronary artery disease.” by Gerardo Ledesma-Gil et al. BMJ Open Ophthalmology
Subretinal drusenoid deposits are strongly associated with high-risk coronary artery disease.
Background / Objectives
show that subretinal drusenoid deposits (SDD) in age-related macular degeneration (AMD) are associated with coexisting high-risk vascular diseases (HRVDs).
A cross-sectional study. Two hundred AD subjects (aged 51–100 years, 121 women, 79 men) were recruited. Spectral domain optical coherence tomography, autofluorescence and near-infrared reflectance imaging and lipid profiles were obtained. Subjects were classified by health history questionnaires into those with or without HRVD: heart valve defects (eg, aortic stenosis), myocardial defects (eg, myocardial infarction), and stroke/transient ischemic attack. Masked readers grouped subjects into two groups: SDD (with or without Drazin) and Drum (only). The univariate test was performed with χ2 We constructed multivariate regression models to test the association between test coexistence HRVD and SDD status, lipid levels, and other covariates.
The prevalence of HRVD in the SDD and non-SDD groups was 41.2% (40/97) and 6.8% (7/103), respectively (correlation of SDD with HRVD, p=9×10).-9, OR 9.62, 95% CI 4.04 to 22.91). Multivariate regression: only SDS and high-density lipoprotein (HDL) in the first two HDL quartiles remained significant for HRVD (p=9.8×10-5, 0.021, respectively). Multivariate regression model: SDDs and HDL identified the presence of HRVD at Q1 or Q2 with an accuracy of 78.5%, 95% CI 72.2% to 84.0%.
High-risk cardiovascular and neurovascular diseases were significantly different from HDL and HDL levels in the AMD group. SDDs may be related to inadequate ocular perfusion resulting from systemic vasculopathies. Further research into this paradigm is warranted and may reduce the mortality and morbidity of vascular disease.