Risk factors for the progression of age-related macular degeneration in patients of the Ukrainian population

Background: Researchers need to find informative age-related macular degeneration (AMD) criteria which could be used for developing expert systems for the prediction of the course of the disease. Purpose: To evaluate risk factors of AMD progression on the basis of clinical and ophthalmological char...

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Main Authors: Sergiy Mogilevskyy, Tetiana Zavgorodnia
Format: Article
Language:English
Published: Ukrainian Society of Ophthalmologists 2024-02-01
Series:Journal of Ophthalmology
Subjects:
Online Access:https://ua.ozhurnal.com/index.php/files/article/view/125
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author Sergiy Mogilevskyy
Tetiana Zavgorodnia
author_facet Sergiy Mogilevskyy
Tetiana Zavgorodnia
author_sort Sergiy Mogilevskyy
collection DOAJ
description Background: Researchers need to find informative age-related macular degeneration (AMD) criteria which could be used for developing expert systems for the prediction of the course of the disease. Purpose: To evaluate risk factors of AMD progression on the basis of clinical and ophthalmological characteristics in patients of the Ukrainian population. Material and Methods: Totally, 302 eyes (152 patients) with AMD were included in the study. The stage of AMD was determined based on the Age-related Eye Disease Study (AREDS) guidelines. Median patient age (95% confidence interval (CI)) was 71.18 (69.47 – 72.89) years, most (82.9%) patients were of 60 – 85 years, and the percentage of women was 59.9%. Visual acuity, best-corrected visual acuity (BCVA), numbers of small, intermediate and large drusen, presence of retinal pigment epithelium (RPE) changes, subretinal neovascular membranes (SNM), and geographic RPE atrophy were assessed at baseline and at 1 year and 2 years. Statistical analyses were conducted using MedStat and MedCalc v.15.1 (MedCalc Software bvba, Ostende, Belgium) and EZR v.1.64 software (R Foundation for Statistical Computing, Austria). Results: There was a slow but statistically significant reduction in median BCVA (interquartile range (IQR)) from 0.4 (0.1–0.85) at baseline to 0.325 (0.1 – 0.8) (p < 0.001) at 2 years. Over the first year and over the second year, the frequency of RPE changes increased by 6.3% and 10.9%, respectively (p < 0.001), the frequency of SNM detection increased by 13.3% and 21.2%, respectively (p < 0.001), and the frequency of geographic atrophy detection, by 5.7% and 8.0%, respectively (p < 0.001). A multivariate logistic regression model was developed to select four covariates for the risk of AMD progression (the male gender, BCVA, number of small drusen and AREDS category at baseline). The BCVA was negatively associated (р = 0.026; OR = 0.12; 95% CI, 0.03 – 0.60), whereas the number of small drusen was positively associated with the risk of AMD progression (р = 0.009; OR = 1.02; 95% CI, 1.00–1.04). The risk of AMD progression was the highest for eyes with the AREDS category 2 (63.0%, 95% CI, 48.7% – 75.7 %), and the lowest for eyes with the AREDS category 3 (41.2 %, 95% CI, 29.4% – 53.8%, р = 0.049). Conclusion: First, over 24 months, we observed a slow but statistically significant reduction in visual acuity, with an increase in the frequency of RPE changes and detection of SNM and geographic atrophy. Second, a multivariate logistic regression model was developed to select four covariates for the risk of AMD progression (the male gender, BCVA, number of small drusen and AREDS category at baseline). The BCVA was negatively associated, whereas the number of small drusen was positively associated with the risk of AMD progression. Finally, the risk of AMD progression was the highest for eyes with the AREDS category 2, and the lowest for eyes with the AREDS category 3.
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spelling doaj.art-5fda6d48b5d3441cb78779510281c77f2024-03-07T13:47:32ZengUkrainian Society of OphthalmologistsJournal of Ophthalmology2412-87402024-02-011374310.31288/oftalmolzh202413743Risk factors for the progression of age-related macular degeneration in patients of the Ukrainian populationSergiy Mogilevskyy0Tetiana Zavgorodnia1Shupyk National Healthcare University of UkraineShupyk National Healthcare University of UkraineBackground: Researchers need to find informative age-related macular degeneration (AMD) criteria which could be used for developing expert systems for the prediction of the course of the disease. Purpose: To evaluate risk factors of AMD progression on the basis of clinical and ophthalmological characteristics in patients of the Ukrainian population. Material and Methods: Totally, 302 eyes (152 patients) with AMD were included in the study. The stage of AMD was determined based on the Age-related Eye Disease Study (AREDS) guidelines. Median patient age (95% confidence interval (CI)) was 71.18 (69.47 – 72.89) years, most (82.9%) patients were of 60 – 85 years, and the percentage of women was 59.9%. Visual acuity, best-corrected visual acuity (BCVA), numbers of small, intermediate and large drusen, presence of retinal pigment epithelium (RPE) changes, subretinal neovascular membranes (SNM), and geographic RPE atrophy were assessed at baseline and at 1 year and 2 years. Statistical analyses were conducted using MedStat and MedCalc v.15.1 (MedCalc Software bvba, Ostende, Belgium) and EZR v.1.64 software (R Foundation for Statistical Computing, Austria). Results: There was a slow but statistically significant reduction in median BCVA (interquartile range (IQR)) from 0.4 (0.1–0.85) at baseline to 0.325 (0.1 – 0.8) (p < 0.001) at 2 years. Over the first year and over the second year, the frequency of RPE changes increased by 6.3% and 10.9%, respectively (p < 0.001), the frequency of SNM detection increased by 13.3% and 21.2%, respectively (p < 0.001), and the frequency of geographic atrophy detection, by 5.7% and 8.0%, respectively (p < 0.001). A multivariate logistic regression model was developed to select four covariates for the risk of AMD progression (the male gender, BCVA, number of small drusen and AREDS category at baseline). The BCVA was negatively associated (р = 0.026; OR = 0.12; 95% CI, 0.03 – 0.60), whereas the number of small drusen was positively associated with the risk of AMD progression (р = 0.009; OR = 1.02; 95% CI, 1.00–1.04). The risk of AMD progression was the highest for eyes with the AREDS category 2 (63.0%, 95% CI, 48.7% – 75.7 %), and the lowest for eyes with the AREDS category 3 (41.2 %, 95% CI, 29.4% – 53.8%, р = 0.049). Conclusion: First, over 24 months, we observed a slow but statistically significant reduction in visual acuity, with an increase in the frequency of RPE changes and detection of SNM and geographic atrophy. Second, a multivariate logistic regression model was developed to select four covariates for the risk of AMD progression (the male gender, BCVA, number of small drusen and AREDS category at baseline). The BCVA was negatively associated, whereas the number of small drusen was positively associated with the risk of AMD progression. Finally, the risk of AMD progression was the highest for eyes with the AREDS category 2, and the lowest for eyes with the AREDS category 3.https://ua.ozhurnal.com/index.php/files/article/view/125aredsvisual acuitydrusenrpe changessubretinam neovascular membranegeographic atrophymodel of disease progression
spellingShingle Sergiy Mogilevskyy
Tetiana Zavgorodnia
Risk factors for the progression of age-related macular degeneration in patients of the Ukrainian population
Journal of Ophthalmology
areds
visual acuity
drusen
rpe changes
subretinam neovascular membrane
geographic atrophy
model of disease progression
title Risk factors for the progression of age-related macular degeneration in patients of the Ukrainian population
title_full Risk factors for the progression of age-related macular degeneration in patients of the Ukrainian population
title_fullStr Risk factors for the progression of age-related macular degeneration in patients of the Ukrainian population
title_full_unstemmed Risk factors for the progression of age-related macular degeneration in patients of the Ukrainian population
title_short Risk factors for the progression of age-related macular degeneration in patients of the Ukrainian population
title_sort risk factors for the progression of age related macular degeneration in patients of the ukrainian population
topic areds
visual acuity
drusen
rpe changes
subretinam neovascular membrane
geographic atrophy
model of disease progression
url https://ua.ozhurnal.com/index.php/files/article/view/125
work_keys_str_mv AT sergiymogilevskyy riskfactorsfortheprogressionofagerelatedmaculardegenerationinpatientsoftheukrainianpopulation
AT tetianazavgorodnia riskfactorsfortheprogressionofagerelatedmaculardegenerationinpatientsoftheukrainianpopulation