Background The associations of geographic atrophy (GA) progression with systemic health status and medication use are unclear.
Methods We manually delineated GA in 318 eyes in the Age-Related Eye Disease Study. We calculated GA perimeter-adjusted growth rate as the ratio between GA area growth rate and mean GA perimeter between the first and last visit for each eye (mean follow-up=5.3 years). Patients’ history of systemic health and medications was collected through questionnaires administered at study enrolment. We evaluated the associations between GA perimeter-adjusted growth rate and 27 systemic health factors using univariable and multivariable linear mixed-effects regression models.
Results In the univariable model, GA perimeter-adjusted growth rate was associated with GA in the fellow eye at any visit (p=0.002), hypertension history (p=0.03), cholesterol-lowering medication use (p<0.001), beta-blocker use (p=0.02), diuretic use (p<0.001) and thyroid hormone use (p=0.03). Among the six factors, GA in the fellow eye at any visit (p=0.008), cholesterol-lowering medication use (p=0.002), and diuretic use (p<0.001) were independently associated with higher GA perimeter-adjusted growth rate in the multivariable model. GA perimeter-adjusted growth rate was 51.1% higher in patients with versus without cholesterol-lowering medication use history and was 37.8% higher in patients with versus without diuretic use history.
Conclusions GA growth rate may be associated with the fellow eye status, cholesterol-lowering medication use, and diuretic use. These possible associations do not infer causal relationships, and future prospective studies are required to investigate the relationships further.
- treatment medical
Data availability statement
Data are available upon reasonable request.
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Contributors LLS was involved in conception and design. LLS, MS, AA, MMP and BKY were involved in data collection. LLS was involved in data analysis. LLS and LVDP were involved in data interpretation. LLS and LVDP obtained funding. LLS, MS, AA, MMP, BKY and LVDP were involved in manuscript writing
Funding This publication was made possible by the James G. Hirsch Endowed Medical Student Research Fellowship from Yale School of Medicine (Grant number: None; Recipient: Shen) and P30 EY026878 from the National Eye Institute (NEI) (Recipient: Yale Vision Science Core).
Disclaimer The sponsor or funding organisation had no role in the design or conduct of this research. The content is solely the responsibility of the authors and does not necessarily represent the official views of the institution or funder.
Competing interests LLS is consultant with Boehringer Ingelheim. LVDP is consultant with Astellas Institute for Regenerative Medicine, LambdaVision and Boehringer Ingelheim; is in the scientific advisory board of Tissue Regeneration Sciences; and is scientific and clinical advisor in CavTheRx.
Provenance and peer review Not commissioned; externally peer reviewed.
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