The association of prior cytomegalovirus infection with neovascular age-related macular degeneration

Daniel M. Miller, Diego Gabriel Espinosa Heidmann, Jessica Legra, Sander R. Dubovy, Ivan J. Sũner, Daniel D. Sedmak, Richard D. Dix, Scott W. Cousins

Research output: Contribution to journalArticle

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Abstract

Purpose To determine if prior exposure to pathogens associated with vascular disease, cytomegalovirus, Chlamydia pneumoniae, and Helicobacter pylori correlates with neovascular age-related macular degeneration (AMD). Design An experimental study. Methods Setting Institutional. Bascom Palmer Eye Institute, October 2001 to December 2002. Patient population 150 patients (47 neovascular amd, 36 dry amd, and 67 non-amd controls) were included in the study. exclusion criteria included hiv infection, malignancy, recent acute illness requiring hospitalization within 6 months, or immunosuppressive illness. Procedure Serum samples were obtained for analysis of cytomegalovirus, chlamydia pneumoniae, and helicobacter pylori igg antibody titers by elisa. Main outcome measure Comparison of the distribution of igg titers between patients with wet amd, dry amd, and controls. Results The average cytomegalovirus IgG titer was higher in patients with wet AMD versus controls (p = 0.02, Student t-test, two-tailed) and patients with dry AMD (p = 0.06). Twenty-six (55%) of 47 subjects with wet AMD had high cytomegalovirus IgG titers compared with 14 (39%) of 36 patients with dry AMD (odds ratio [OR] = 2.23, 95% confidence interval [CI] = 0.77 to 6.44) and 23 (34%) of 67 control patients (OR = 2.49, 95% CI = 0.98 to 6.33). There was no major difference in the distribution of titers for Chlamydia pneumoniae IgG and Helicobacter pylori IgG in wet and dry AMD patients. Five of 47 patients with wet AMD (11%) had high antibody titers to all three pathogens, compared with only 1 of 36 patients with dry AMD (3%) (OR = 4.17, 95% CI = 0.46 to 37.36). Conclusions There was a significant association of high cytomegalovirus IgG titer with neovascular AMD compared with dry AMD and control patients. Chronic infection with cytomegalovirus may be a novel risk factor for the progression from dry to neovascular AMD.

Original languageEnglish (US)
Pages (from-to)323-328
Number of pages6
JournalAmerican Journal of Ophthalmology
Volume138
Issue number3
DOIs
StatePublished - Sep 1 2004

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Cytomegalovirus Infections
Macular Degeneration
Cytomegalovirus
Immunoglobulin G
Chlamydophila pneumoniae
Helicobacter pylori
Odds Ratio
Confidence Intervals
Antibodies
Immunosuppressive Agents
Vascular Diseases
Hospitalization
Research Design
Outcome Assessment (Health Care)
Students

ASJC Scopus subject areas

  • Ophthalmology

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The association of prior cytomegalovirus infection with neovascular age-related macular degeneration. / Miller, Daniel M.; Espinosa Heidmann, Diego Gabriel; Legra, Jessica; Dubovy, Sander R.; Sũner, Ivan J.; Sedmak, Daniel D.; Dix, Richard D.; Cousins, Scott W.

In: American Journal of Ophthalmology, Vol. 138, No. 3, 01.09.2004, p. 323-328.

Research output: Contribution to journalArticle

Miller, Daniel M. ; Espinosa Heidmann, Diego Gabriel ; Legra, Jessica ; Dubovy, Sander R. ; Sũner, Ivan J. ; Sedmak, Daniel D. ; Dix, Richard D. ; Cousins, Scott W. / The association of prior cytomegalovirus infection with neovascular age-related macular degeneration. In: American Journal of Ophthalmology. 2004 ; Vol. 138, No. 3. pp. 323-328.
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abstract = "Purpose To determine if prior exposure to pathogens associated with vascular disease, cytomegalovirus, Chlamydia pneumoniae, and Helicobacter pylori correlates with neovascular age-related macular degeneration (AMD). Design An experimental study. Methods Setting Institutional. Bascom Palmer Eye Institute, October 2001 to December 2002. Patient population 150 patients (47 neovascular amd, 36 dry amd, and 67 non-amd controls) were included in the study. exclusion criteria included hiv infection, malignancy, recent acute illness requiring hospitalization within 6 months, or immunosuppressive illness. Procedure Serum samples were obtained for analysis of cytomegalovirus, chlamydia pneumoniae, and helicobacter pylori igg antibody titers by elisa. Main outcome measure Comparison of the distribution of igg titers between patients with wet amd, dry amd, and controls. Results The average cytomegalovirus IgG titer was higher in patients with wet AMD versus controls (p = 0.02, Student t-test, two-tailed) and patients with dry AMD (p = 0.06). Twenty-six (55{\%}) of 47 subjects with wet AMD had high cytomegalovirus IgG titers compared with 14 (39{\%}) of 36 patients with dry AMD (odds ratio [OR] = 2.23, 95{\%} confidence interval [CI] = 0.77 to 6.44) and 23 (34{\%}) of 67 control patients (OR = 2.49, 95{\%} CI = 0.98 to 6.33). There was no major difference in the distribution of titers for Chlamydia pneumoniae IgG and Helicobacter pylori IgG in wet and dry AMD patients. Five of 47 patients with wet AMD (11{\%}) had high antibody titers to all three pathogens, compared with only 1 of 36 patients with dry AMD (3{\%}) (OR = 4.17, 95{\%} CI = 0.46 to 37.36). Conclusions There was a significant association of high cytomegalovirus IgG titer with neovascular AMD compared with dry AMD and control patients. Chronic infection with cytomegalovirus may be a novel risk factor for the progression from dry to neovascular AMD.",
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AU - Legra, Jessica

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AU - Sũner, Ivan J.

AU - Sedmak, Daniel D.

AU - Dix, Richard D.

AU - Cousins, Scott W.

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AB - Purpose To determine if prior exposure to pathogens associated with vascular disease, cytomegalovirus, Chlamydia pneumoniae, and Helicobacter pylori correlates with neovascular age-related macular degeneration (AMD). Design An experimental study. Methods Setting Institutional. Bascom Palmer Eye Institute, October 2001 to December 2002. Patient population 150 patients (47 neovascular amd, 36 dry amd, and 67 non-amd controls) were included in the study. exclusion criteria included hiv infection, malignancy, recent acute illness requiring hospitalization within 6 months, or immunosuppressive illness. Procedure Serum samples were obtained for analysis of cytomegalovirus, chlamydia pneumoniae, and helicobacter pylori igg antibody titers by elisa. Main outcome measure Comparison of the distribution of igg titers between patients with wet amd, dry amd, and controls. Results The average cytomegalovirus IgG titer was higher in patients with wet AMD versus controls (p = 0.02, Student t-test, two-tailed) and patients with dry AMD (p = 0.06). Twenty-six (55%) of 47 subjects with wet AMD had high cytomegalovirus IgG titers compared with 14 (39%) of 36 patients with dry AMD (odds ratio [OR] = 2.23, 95% confidence interval [CI] = 0.77 to 6.44) and 23 (34%) of 67 control patients (OR = 2.49, 95% CI = 0.98 to 6.33). There was no major difference in the distribution of titers for Chlamydia pneumoniae IgG and Helicobacter pylori IgG in wet and dry AMD patients. Five of 47 patients with wet AMD (11%) had high antibody titers to all three pathogens, compared with only 1 of 36 patients with dry AMD (3%) (OR = 4.17, 95% CI = 0.46 to 37.36). Conclusions There was a significant association of high cytomegalovirus IgG titer with neovascular AMD compared with dry AMD and control patients. Chronic infection with cytomegalovirus may be a novel risk factor for the progression from dry to neovascular AMD.

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