Wet Age-Related Macular Degeneration Linked to Hypertension

Exudative age-related macular degeneration (wet AMD) is associated with hypertension status, according to a study published in Acta Ophthalmologica.

While both AMD and hypertension are common among older patients, the relationship between the 2 diseases is unknown. The researchers investigated the relationship and the treatment strategy of patients with wet AMD affected by hypertension.

They retrospectively identified medical records of 3096 patients older than 50 years with wet AMD in Zhongshan Ophthalmic Center (ZOC), a public ophthalmology hospital in China. They reviewed whether vitrectomy surgery was performed and presence of other diseases from 2002 to June 2019.

To determine hypertension status, the researchers reviewed whether the patients were on hypertensive therapy, in which case they were identified as hypertensive. Patients who were not on hypertensive therapy were asked to rest for 15 minutes. If their subsequent systolic pressure was above 140 mm Hg, or diastolic pressure were above 90 mm Hg, they were identified as hypertensive.

Since ranibizumab was the first anti-vascular endothelial growth factor (VEGF) drug to treat wet AMD at the hospital and was used by the largest number of patients, only those receiving the treatment were included, and patients who had received other intravitreal therapies were excluded. They divided the patients who received injections into 2 categories based on whether they had received 1-3 injections (group A) or more than 3 injections (group B). 

The researchers found a significant association between wet AMD and hypertension that indicated that patients with hypertension had a higher chance of developing wet AMD than patients without hypertension. Of the 3096 patients (of 224,334 patients total in ZOC) diagnosed with wAMD, 380 had been diagnosed with hypertension.

There were 1386 wet AMD patients who used anti-VEGF drugs. Among patients with wet AMD, more women had hypertension than men (P =.013). Men with wet AMD received more injections than women, the report said (P =.006).

Cox regression model showed a statistically significant association between hypertension in wet AMD patients and the number of injections (relative risk (RR)=1.28, P =.001). Adjusting for age and sex, RR was 1.30 (P <.001) in the regression model.

Patients who underwent vitrectomy surgeries were included when their main diagnosis was wet AMD from 2012 through June 2019. A total of 650 wet AMD patients (73 with hypertension) underwent vitrectomy surgery. After adjusting for age and sex, undergoing the procedure was not associated with hypertension (P =.82).

Limitations of the study included all data records coming from 1 eye hospital and some wet AMD patients received their follow-up injections at their local hospital instead of the original hospital.

Reference

Wang T, Xia J, Yuan M, et al. Hypertension affects the treatment of wet age-related macular degeneration. Acta Ophthalmologica. Published online March 31, 2021. doi:10.1111/aos.14791