AMD May Progress at a Similar Rate in the Other Eye

By Reuters Staff

October 28, 2014

NEW YORK (Reuters Health) - The severity of age-related macular degeneration (AMD) in one eye seems to pace the rate of degeneration in the other eye, new research has found.

"In a cohort that was observed for 20 years, we showed that AMD severity in one eye largely tracks AMD severity in the fellow eye at all stages of the disease," Dr. Ronald Klein of the University of Wisconsin in Madison and his colleagues wrote online October 23 in JAMA Ophthalmology.

The data are from nearly 4400 patients in the Beaver Dam Eye Study. Researchers recorded disease progression every five years for 20 years and rated the severity of degeneration on a scale of one to five, in which a "one" is a hard, or a small, soft drusen, and a "five" is late-stage disease.

When degeneration was more severe in one eye than the other, the other eye had a higher risk of developing the condition or of accelerated progression, the researchers found.

In a given eye, for example, "progression was more common, and regression less common, if the severity in the fellow eye was worse (progression: 4% if same vs 16% if worse for level 1, 14% if better vs 25% if same vs 31% if worse for level 2, 12% vs 27% vs 38% for level 3, 15% vs 26% vs 28% for level 4."

The pattern for regression was "14% vs 5% vs 4% for level 2, 16% vs 8% vs 1% for level 3, 13% if same vs 1% if worse for level 4," the authors reported.

Also, they found, "More severe AMD in one eye was associated with an increased incidence of AMD and accelerated progression in its fellow eye (from level 1 to level 2: HR, 4.90; from level 2 to level 3: HR, 2.09; from level 3 to level 4: HR, 2.38; from level 4 to level 5: HR, 2.46)."

In contrast, less severe AMD in one eye was linked with a lower risk of AMD progression in the other eye (from level 2 to level 3: HR, 0.42; from level 3 to level 4: HR, 0.50).

"We estimate that 51% of participants who develop any AMD always maintain AMD severity states within 1 step of each other between eyes; 90% of participants stay within 2 steps," the researchers write.

Dr. Klein did not respond to a request for comment before the publication deadline.

SOURCE: http://bit.ly/1nK8tX1

JAMA Ophthalmol 2014.

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