The subretinal drusenoid deposition (SDD) type of age-related macular degeneration (AMD) is associated with decreased systemic perfusion due to valvular heart disease (VHD) and cardiac index (CI), according to a study published in 2017. european ophthalmology journal. This information may support the perfusion hypothesis of SDD development.

AMD, the most common cause of legal blindness, is characterized by SDD as the primary lesion associated with the disease. Previous studies have found an association between SDD and high-risk vascular disease in patients with intermediate AMD (iAMD), but this study relied on self-reported data. In this study, using transthoracic echocardiography (TTE) he measured the health of the four major heart valves and found that cardiac dysfunction and his VHD were associated with SDD with and without soft drusen. We evaluated the theory that

Blue eyes | Photo Blue eyes Image credit: Liudmila Dutko – Stock.adobe.com

The current study used a cross-sectional study as the basis for a post-hoc analysis and included 200 patients with iAMD at Mount Sinai School of Medicine and New York Vitreoretinal Macular Consultants in New York City. All data were collected between August 2019 and November 2021, with a 14-month interruption due to the COVID-19 pandemic. All patients were between 51 and 100 years old and had iAMD in at least one eye, and patients with bilateral progressive AMD or other retinal degeneration and retinal vascular disease were excluded.

All participants had spectral-domain optical coherence tomography (SD-OCT) images taken, and all were analyzed for SDD. TTE was collected from all patients’ electronic medical records. If there was more than one TTE, the most recent TTE was used, and if available, the CI was calculated using the TTE.

Of the 200 patients in the cross-sectional study, 65 patients had TTE, 38 were classified into the SDD group, and 27 were classified into the non-SDD group. The mean (SD) age of participants was 79.78 (8.94) years in the SDD group and 81.26 (7.66) years in the non-SDD group.

19 of the patients in the SDD group had VHD of moderate severity compared with 4 patients in the non-SDD group, and SDD was found in all patients with multivalve VHD. Aortic regurgitation of moderate or greater severity and mitral regurgitation of moderate or greater severity were more frequent in patients with SDD.Presence of aortic sclerosis (ASc)) It was found in 29 patients in the SDD group versus 12 in the non-SDD group. Mitral annular calcification (MAC)) was found in 19 patients in the SDD group and 6 in the non-SDD group. The results showed that there was a significant association between ASc, MAC, and SDD.

SDD is associated with a thinner choroid, and the mean uterine eye (OU) of the SDD group was 143.03 (49.14) μm, whereas the mean OU of the non-SDD group was 179.04 (70.29) μm. SDD was also associated with a decrease in her CI, as the patient’s levels in the non-SDD group were normal compared to the decrease in levels in the SDD group.

This study had several limitations, including a small sample size of 65 participants and only 48 who underwent CI testing. Furthermore, the raw TTE images were not available for examination by the cardiologist. Smoking within the past 6 months and being female were more common in her SDD group, and these factors were more commonly associated with her SDD and VHD. However, univariate analysis revealed that these factors were not statistically significant.

“Taken together, these findings suggest that ophthalmologists who detect SDD on examination should prompt referral to a cardiologist for standard testing for vascular disease,” the researchers concluded. “Policies should harness the power of direct testing such as this for early detection of blindness and life-threatening diseases in public health.”

reference

Fei Y, Joe JJ, Chen S, et al. Quantification of cardiac dysfunction and valvular heart disease associated with subretinal drusenoid deposition in age-related macular degeneration. Euro J Oftal Mall. Published online March 28, 2024. doi:10.1177/11206721241244413