TY - JOUR
T1 - The association of prior cytomegalovirus infection with neovascular age-related macular degeneration
AU - Miller, Daniel M.
AU - Espinosa-Heidmann, Diego G.
AU - Legra, Jessica
AU - Dubovy, Sander R.
AU - Sũner, Ivan J.
AU - Sedmak, Daniel D.
AU - Dix, Richard D.
AU - Cousins, Scott W.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2004/9
Y1 - 2004/9
N2 - 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.
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.
UR - http://www.scopus.com/inward/record.url?scp=4444335830&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=4444335830&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2004.03.018
DO - 10.1016/j.ajo.2004.03.018
M3 - Article
C2 - 15364212
AN - SCOPUS:4444335830
SN - 0002-9394
VL - 138
SP - 323
EP - 328
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
IS - 3
ER -