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Clinical science
Evaluation of coronary artery disease as a risk factor for reticular pseudodrusen
  1. Rachel V McCarter1,
  2. Gareth J McKay1,
  3. Nicola B Quinn1,
  4. Usha Chakravarthy1,
  5. Tom J MacGillivray2,
  6. Gavin Robertson2,
  7. Enrico Pellegrini2,
  8. Emanuele Trucco3,
  9. Michelle C Williams4,
  10. Tunde Peto1,
  11. Baljean Dhillon2,
  12. Edwin JR van Beek5,
  13. David E Newby4,
  14. Frank Kee1,
  15. Ian S Young1,
  16. Ruth E Hogg1
  1. 1Centre for Public Health, Queen’s University Belfast, Belfast, UK
  2. 2VAMPIRE Project, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
  3. 3VAMPIRE Project, Computing, School of Science and Engineering, University of Dundee, Dundee, UK
  4. 4Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
  5. 5Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Ruth E Hogg, Center for Public Health, Queen’s University Belfast, Institute of Clinical Sciences, 1 Block A, Royal Hospital, Grosvenor Road, Belfast BT12 6BA, Northern Ireland; r.e.hogg{at}qub.ac.uk

Abstract

Purpose Reticular pseudodrusen (RPD) are a risk factor for late age-related macular degeneration (AMD). Associations between RPD and coronary artery disease (CAD) have been reported from small case–control studies. This study investigated the association of RPD within a predominantly CAD cohort.

Methods A subgroup of subjects from a multicentre randomised controlled trial of CT coronary angiography (CTCA) underwent ultrawide field (UWF) retinal imaging CAD determined by CTCA and was categorised as normal, non-obstructive or obstructive. Specific AMD features in UWF images were graded. Standardised grids were used to record the spatial location of AMD features, including RPD. Multivariate confounder adjusted regression models assessed the association between RPD and CAD.

Results The 534 participants were aged 27–75 years (mean 58±9 years; 425 (80%) ≥50 years) with a male preponderance (56%). Within the study sample, 178 (33%) had no CAD, 351 (66%) had CAD. RPD was detected in 30 participants (5.6%) and bilaterally in 23. Most participants with bilateral RPD had intermediate AMD 17 (74%). After adjustment for potential confounders (age, sex, drusen >125 µm, smoking status), multivariate analysis found no significant association between CAD and RPD (OR 1.31; 95% CI (0.57 to 3.01); p=0.52). A significant association was identified between RPD and intermediate AMD (OR 3.18; 95% CI (1.61 to 6.27); p=0.001).

Conclusion We found no evidence to support an association between CAD and RPD. RPD was strongly associated with intermediate AMD features.

Trial registration number NCT01149590, Post results.

  • retina
  • epidemiology
  • imaging

https://doi.org/10.1136/bjophthalmol-2017-310526

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    Footnotes

    • Contributors The corresponding author and all of the authors have made the following contributions: (1) conception and design, or acquisition of data, or analysis and interpretation of data; (2) drafting the article and/or reviewing, revising it critically for important intellectual content; (3) final approval of the version to be published. REH: (1), (2), (3). RVM: (1), (2), (3). GJM: (1), (2), (3). NBQ: (1), (2), (3). UC: (2), (3). TJM: (1), (3). GR: (1), (3). EP: (1), (3). ET: (1), (3). MCW: (1), (3). TP: (1), (3). BD: (1), (3). EJRvB: (1), (3). DEN: (1), (3). FK: (1), (3). ISY: (1), (3).

    • Funding The Chief Scientist Office of the Scottish Government Health and Social Care Directorates funded the SCOT-HEART trial with supplementary awards from Edinburgh and Lothian’s Health Foundation Trust and the Heart Diseases Research Fund.

    • Competing interests FK and ISY are the study principal investigator and study originator of NICOLA.

    • Patient consent Obtained.

    • Ethics approval Research Ethics Committee, Scotland.

    • Provenance and peer review Not commissioned; externally peer reviewed.