Articles about Eye Health and Disease 2003
 

Worsening of Age-Related Macular Degeneration is Associated With Body Mass Index, Waist Circumference, and Waist-Hip Ratio

(From Johanna M. Seddon, MD, et al., Arch Ophthalmol. 2003;121:785-792.)

Individuals with early or intermediate stages of age-related macular degeneration (AMD) make up a large and growing segment of our elderly population. To advise these high-risk patients regarding preventive measures, this study evaluated anthropomorphic (body type and build), behavioral, and medical factors associated with progression to the advanced stages of AMD associated with visual loss. The study design was a prospective cohort study in a hospital-based retinal practice. The 261 participants were 60 years or older, with some sign of non-advanced AMD and visual acuity of 20/200 or better in at least 1 eye. The average follow-up time was 4.6 years, and the total person-years of follow-up was 1198.

Results:

• Higher body mass index (calculated as weight in kilograms divided by the square of height in meters) increased the risk for progression to the advanced forms of AMD. Relative risk of progression was 2.35 greater for a body mass index of at least 30, and 2.32 greater for a body mass index of 25 to 29, relative to the lowest category (<25) after controlling for other factors.

• Higher waist circumference was associated with a 2-fold increased risk for progression, with a significant trend for increasing risk with a greater waist circumference.

• Higher waist-hip ratio also increased the risk for progression for the highest third compared with lowest.

• More physical activity tended to be associated with a reduced rate of progression (25% reduction for 3 times per week vigorous activity vs none).

• Relative risks for smoking ranged from 1.48 to 1.99, but were not statistically significant.

Conclusions: These results provide new information regarding modifiable factors for individuals with the early or intermediate stages of this disease. Overall and abdominal obesity increased the risk for progression to advanced AMD, and more physical activity tended to decrease risk. These preventive measures deserve additional research and greater emphasis.

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