Emphysema, airflow limitation, and early age-related macular degeneration

Abstract

Objective: To describe the associations of lung function and emphysema, measured with spirometry and computed tomography (CT), with early age-related macular degeneration (AMD) in a sample of white, black, Hispanic, and Chinese subjects. Methods: Three thousand three hundred ninety-nine persons aged 45 to 84 years residing in 6 US communities participated in a period cross-sectional study. Age-related macular degeneration was measured from digital retinal photographs at the second Multi-Ethnic Study of Atherosclerosis (MESA) examination. Forced expiratory volume in 1 second (FEV1) and FEV 1 to forced vital capacity (FVC) ratio were measured at the third or fourth MESA examination. Percent emphysema was measured from cardiac CT scans at baseline. Apical and basilar lung segments were defined as the cephalad or caudal regions of the lung on the cardiac CT scan. Logistic regression models were used to examine the association of lung function and structure with AMD, controlling for age, sex, and other factors. Results: The prevalence of early AMD was 3.7%. Early AMDwas not associated with FEV1 (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.58-1.15; P=.25), FEV1: FVC ratio (OR, 0.92; 95% CI, 0.76-1.12; P=.43), percent emphysema (OR, 1.13; 95% CI, 0.91-1.40; P=.26), and apical-basilar difference in percent emphysema (OR, 1.14;95% CI, 0.95-1.37; P=.17). Associations were stronger in smokers. Apical-basilar difference in percent emphysema was significantly associated with earlyAMD among thosewhoever smoked (OR, 1.28; 95% CI, 1.02-1.60; P=.03). Associations were not modified by race/ethnicity. Conclusions: Lung function and emphysema on CT scan were not cross-sectionally associated withAMD;this might be explained by the relatively low smoking exposure in this cohort. ©2010 American Medical Association. All rights reserved.