Heart Disease, Eye Condition Share Common Link

A study by researchers at the University of Sidney has found a link between age-related macular degeneration (AMD) and an increased risk of heart attack and stroke. People with AMD were found to have twice the risk of dying due to cardiovascular conditions, the researchers said.

AMD affects the centre of the retina (macula) at the back of the eye, a part necessary for fine central vision tasks such as reading and driving. There are two forms of the condition – wet and dry – with the dry form being more common. The wet type however, is more aggressive and 90% of all blindness caused by AMD is due to this type. It largely affects the elderly and is estimated to affect 500,000 people just in the UK, with more than 20,000 new cases of wet AMD diagnosed each year.

The study from Sydney covering 3,600 people aged 49 and above assessed the general and eye health of participants at the beginning and then followed up 2,335 people five and 1,952 people 10 years later respectively. The researchers found that those people under the age of 75 who were diagnosed with early AMD at the start of the study had double the risk of dying from a heart attack or stroke in the next decade.

People who had highly developed AMD at the start of the study were found to be at five times the risk of succumbing to a heart attack and 10 times the risk of dying due to a stroke within the next 10 years. While the results are clear, the researchers are unsure about the link between AMD and cardiovascular disease. Their findings have been published in the British Journal of Ophthalmology.

According to the researchers, AMD might be a sign that increasing age is making the body vulnerable to diseases. Common problems such as inflammation, thickening of the arteries or general tissue damage due to unstable particles called free radicals might also be responsible for both AMD and cardiovascular disease, they said.

At the same time, they did not rule out the possibility of anti-VEGF drugs used for the treatment of AMD increasing the risk of heart attack and stroke. Anti-VEGF drugs are effective against AMD as they inhibit the growth of new blood vessels and it is unstable new blood vessels in the eye leaking fluid and blood under the retina that are responsible for the condition. The leakage leads to scarring and irreversible blindness.

The reason for this opinion is the growing concern that inhibiting blood vessel growth might also affect the cardiovascular system. The researchers said, “Our results suggest that individuals with a high cardiovascular risk profile may potentially need to be monitored closely if receiving anti-VEGF therapy.”

UK experts on the other hand disagree with this opinion as can be seen by the easing of restrictions on NHS use of one of the anti-VEGF drugs by NICE last year. The Sydney researchers too admit that their study was comparatively small and further research is necessary to confirm their findings.

Referring to other studies on similar lines, Mr. Winfried Amoaku, of the Royal College of Ophthalmologists, said that these too found a link between AMD and cardiovascular disease. He however disagreed with the suggestion that anti-VEGF drugs might be involved and said they had been shown to be safe. “The likely reason for the link is vascular degeneration. This is a systemic failure that can affect several parts of the body in relatively quick succession,” he said.

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