Overview: People with subretinal drusenoid deposits (SDD), a form of age-related macular degeneration, are at risk of potential heart damage as a result of heart failure, heart attack, or other forms of cardiovascular disease that are associated with an increased risk of stroke. You are more likely to have
sauce: Mount Sinai Hospital
Patients with certain forms of age-related macular degeneration (AMD), the leading cause of blindness in the United States, may have heart damage from heart failure or stroke, advanced valvular heart disease, or carotid arteries. very high in nature. Arterial disease associated with certain types of stroke, according to a new study from Mount His Sinai’s New York Department of Ophthalmology and Otology.
This study was published on November 17th. BMJ Open Ophthalmologywere the first to identify which types of high-risk cardiovascular and carotid artery disease are associated with eye disorders.
Findings may prompt increased screening to preserve vision, diagnose undetected heart disease, and prevent adverse cardiovascular events.
“For the first time, we were able to link these specific high-risk cardiovascular diseases to a specific form of AMD with subretinal drusenoid deposits (SDD),” explained lead author R. Theodore Smith, M.D., Ph.D. increase. Professor of Ophthalmology, Icahn School of Medicine, Mount Sinai.
“This study is the first strong link between AMD, a leading cause of blindness, and heart disease, a leading cause of death worldwide. Yes, the blood supply to the eye is directly reduced by these diseases, either through damage to the heart, which reduces the blood supply to the whole body, or through blockage of the carotid artery, which directly blocks blood flow to the eye.
Inadequate blood supply can damage any part of the body, and in these particular diseases, the destroyed retina and residual SDD are the damage. Damage to the retina means loss of vision and can lead to blindness. ”
AMD is the leading cause of visual impairment and blindness in people over the age of 65 and is the result of damage to the central area of the retina called the macula, which is responsible for reading and driving vision.
One of the main early forms of AMD consists of tiny yellow cholesterol deposits called drusen that form under a part of the retina called the retinal pigment epithelium (RPE). They deprive the retina of blood and oxygen and can lead to blindness. Drusen formation can be slowed with proper vitamin supplementation.
Subretinal drusenoid deposits (SDD), another major form of early AMD, are less well known and require high-tech retinal imaging to detect. These deposits, containing different forms of cholesterol, form above the RPE and just below the light-sensitive retinal cells, causing damage and loss of vision. There is no known cure for SDD.
Dr. Smith and a team of researchers at Mount Sinai were the first to find that patients with cardiovascular disease or stroke are more likely to develop SDD.The first study of its kind appeared in the July issue of retina.
This new study extends previous studies to examine a wider patient population and identify the specific severe forms of heart and carotid artery disease that cause SDD in AMD.
Researchers analyzed the eyes of 200 AMD patients with retinal imaging to determine which patients had SDD. Patients completed a questionnaire regarding their history of cardiovascular disease. Of the 200 patients, 97 had her SDD and 103 had drusen only.
Of the 200, 47 had severe heart disease (19 heart failure or heart damage due to heart attack, 17 severe valve disease, and 11 carotid stroke).
40 of 47 (86%) had SDD. In contrast, of 153 AMD patients without these serious illnesses, 57 (43%) had SDD.
The researchers concluded that AMD patients with severe cardiovascular disease and stroke were nine times more likely to develop SDD than those without.
“This study demonstrates the fact that ophthalmologists may be the first to detect systemic disease, especially in asymptomatic patients,” said co-investigator, Mount Sinai Health System. said Richard B. Rosen, MD, Head of Retina Service at .
“Detecting SDD in the retina triggers referral to an individual’s primary care provider, especially if no previous cardiologist has been involved. Life-threatening cardiac events can be prevented.”
“This study opens the door to productive interdisciplinary collaboration between ophthalmology, cardiology, and neurology services,” said Jagat Narula, M.D., Ph.D., director of Zena’s cardiovascular imaging program. increase. Icahn College of Medicine, Mount Sinai.
“There is also a need to focus on the definition of disease severity by vascular imaging in cardiology and neurology clinics, and to assess the impact on AMD and SDD using retinal imaging. can help us know which vascular patients need to be referred for the detection and prevention of blinding disease.”
About this vision and cardiovascular research news
author: press office
sauce: Mount Sinai Hospital
contact: Press Office – Mount Sinai Hospital
image: image is public domain
See also
Original research: open access.
“Subretinal drusenoid deposition is strongly associated with coexisting high-risk vascular disease” by Gerald Ledesma Gill et al. BMJ Open Ophthalmology
Overview
Subretinal drusenoid deposition is strongly associated with coexisting high-risk vascular disease
Background/Aim
We demonstrate that subretinal drusenoid deposition (SDD) in age-related macular degeneration (AMD) is associated with comorbid high-risk vascular disease (HRVD).
method
Cross-sectional study. Two hundred AMD subjects (51-100 years old, 121 females, 79 males) were recruited. Spectral domain optical coherence tomography, autofluorescence and near-infrared reflectance imaging, and lipid profiles were obtained. The subject was diagnosed with or without her HRVD, defined by a health history questionnaire as heart valve defects (e.g., aortic stenosis), myocardial defects (e.g., myocardial infarction), and stroke/transient ischemic attack. assigned. A masked reader assigned subjects to her two groups: SDD (with or without drusen) and drusen (only).Univariate tests were performed by χ2 test. A multivariate regression model was constructed to test the relationship between coexisting HRVD and SDD status, lipid levels and other covariates.
result
The prevalence of HRVD was 41.2% (40/97) and 6.8% (7/103) in the SDD and non-SDD groups, respectively (correlation between SDD and HRVD, p=9×10−9, or 9.62, 95% CI 4.04 to 22.91). Multivariate regression: Only the SDD of the first two HDL quartiles and high-density lipoprotein (HDL) remained significant for HRVD (p=9.8 × 10−5, respectively 0.021). Multivariate regression model: Q1 or Q2 SDD and HDL identified the presence of HRVD with an accuracy of 78.5%, 95% CI 72.2% to 84.0%.
Conclusion
High-risk cardiovascular and neurovascular disease were accurately identified in the AMD cohort from SDD and HDL levels. SDD may be associated with inadequate ocular perfusion resulting from systemic vascular disease. Further studies using this paradigm are needed and may reduce mortality and morbidity from vascular disease.
