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Is medication use associated with the incidence of early age-related maculopathy? Pooled findings from 3 continents.
Ophthalmology. 2004 Jun; 111(6):1169-75.O

Abstract

OBJECTIVE

To investigate whether there is an association between the use of medication and the incidence of early age-related maculopathy (ARM).

DESIGN

Pooled data from 3 prospective, population-based cohort studies.

PARTICIPANTS

Subjects without early and late ARM at baseline who participated in the follow-up of the Beaver Dam Eye Study (n = 3012), the Rotterdam Study (n = 3434), and the Blue Mountains Eye Study (n = 2203).

METHODS

Stereoscopic color fundus photographs of all participants were graded according to a standardized protocol. At baseline, current use of prescription and over-the-counter medication was assessed by interview, and the drug name was confirmed at the research centers. Procedures and definitions were similar at both baseline and follow-up across the 3 study sites.

MAIN OUTCOME MEASURES

Incidence of early ARM, defined as the presence at follow-up of either soft distinct drusen with pigmentary changes or soft indistinct or reticular drusen.

RESULTS

In the pooled cohort, 53.3% of participants used at least one of the medications selected for this study. Within a mean period of 5.6 years, a total of 683 subjects developed early ARM. Users of antihypertensive medication in general, and beta-blockers in particular, had a borderline statistically significant increased risk of early ARM (odds ratio [OR] for beta-blockers, 1.3; 95% confidence interval [CI], 1.0-1.6) when adjusted for systolic (or diastolic) blood pressure and other confounders. A protective effect of borderline significance was found among women using hormone replacement therapy (OR, 0.6; 95% CI, 0.4-1.0) and in persons using tricyclic antidepressants (OR, 0.4; 95% CI, 0.2-1.0). In contrast with beta-blockers, the direction and magnitude of the association with hormone replacement therapy and tricyclic antidepressants were inconsistent among the 3 study populations.

CONCLUSIONS

Pooled data from 3 population-based studies showed no strong associations between medication use and the incidence of early ARM. Of borderline significance were a slightly increased risk among users of beta-blockers and a reduced risk among users of hormone replacement therapy and users of tricyclic antidepressants. Although beta-blocker use could be a proxy for systemic hypertension, these findings warrant further investigations, preferably including information on the dosage and duration of drug exposure.

Authors+Show Affiliations

Department of Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15177967

Citation

van Leeuwen, Redmer, et al. "Is Medication Use Associated With the Incidence of Early Age-related Maculopathy? Pooled Findings From 3 Continents." Ophthalmology, vol. 111, no. 6, 2004, pp. 1169-75.
van Leeuwen R, Tomany SC, Wang JJ, et al. Is medication use associated with the incidence of early age-related maculopathy? Pooled findings from 3 continents. Ophthalmology. 2004;111(6):1169-75.
van Leeuwen, R., Tomany, S. C., Wang, J. J., Klein, R., Mitchell, P., Hofman, A., Klein, B. E., Vingerling, J. R., Cumming, R. G., & de Jong, P. T. (2004). Is medication use associated with the incidence of early age-related maculopathy? Pooled findings from 3 continents. Ophthalmology, 111(6), 1169-75.
van Leeuwen R, et al. Is Medication Use Associated With the Incidence of Early Age-related Maculopathy? Pooled Findings From 3 Continents. Ophthalmology. 2004;111(6):1169-75. PubMed PMID: 15177967.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is medication use associated with the incidence of early age-related maculopathy? Pooled findings from 3 continents. AU - van Leeuwen,Redmer, AU - Tomany,Sandra C, AU - Wang,Jie Jin, AU - Klein,Ronald, AU - Mitchell,Paul, AU - Hofman,Albert, AU - Klein,Barbara E K, AU - Vingerling,Johannes R, AU - Cumming,Robert G, AU - de Jong,Paulus T V M, PY - 2003/05/21/received PY - 2003/10/13/accepted PY - 2004/6/5/pubmed PY - 2004/6/29/medline PY - 2004/6/5/entrez SP - 1169 EP - 75 JF - Ophthalmology JO - Ophthalmology VL - 111 IS - 6 N2 - OBJECTIVE: To investigate whether there is an association between the use of medication and the incidence of early age-related maculopathy (ARM). DESIGN: Pooled data from 3 prospective, population-based cohort studies. PARTICIPANTS: Subjects without early and late ARM at baseline who participated in the follow-up of the Beaver Dam Eye Study (n = 3012), the Rotterdam Study (n = 3434), and the Blue Mountains Eye Study (n = 2203). METHODS: Stereoscopic color fundus photographs of all participants were graded according to a standardized protocol. At baseline, current use of prescription and over-the-counter medication was assessed by interview, and the drug name was confirmed at the research centers. Procedures and definitions were similar at both baseline and follow-up across the 3 study sites. MAIN OUTCOME MEASURES: Incidence of early ARM, defined as the presence at follow-up of either soft distinct drusen with pigmentary changes or soft indistinct or reticular drusen. RESULTS: In the pooled cohort, 53.3% of participants used at least one of the medications selected for this study. Within a mean period of 5.6 years, a total of 683 subjects developed early ARM. Users of antihypertensive medication in general, and beta-blockers in particular, had a borderline statistically significant increased risk of early ARM (odds ratio [OR] for beta-blockers, 1.3; 95% confidence interval [CI], 1.0-1.6) when adjusted for systolic (or diastolic) blood pressure and other confounders. A protective effect of borderline significance was found among women using hormone replacement therapy (OR, 0.6; 95% CI, 0.4-1.0) and in persons using tricyclic antidepressants (OR, 0.4; 95% CI, 0.2-1.0). In contrast with beta-blockers, the direction and magnitude of the association with hormone replacement therapy and tricyclic antidepressants were inconsistent among the 3 study populations. CONCLUSIONS: Pooled data from 3 population-based studies showed no strong associations between medication use and the incidence of early ARM. Of borderline significance were a slightly increased risk among users of beta-blockers and a reduced risk among users of hormone replacement therapy and users of tricyclic antidepressants. Although beta-blocker use could be a proxy for systemic hypertension, these findings warrant further investigations, preferably including information on the dosage and duration of drug exposure. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/15177967/Is_medication_use_associated_with_the_incidence_of_early_age_related_maculopathy_Pooled_findings_from_3_continents_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(04)00139-3 DB - PRIME DP - Unbound Medicine ER -