Association of Age-Related Macular Degeneration With Mortality: A Propensity Score-Matched Analysis

PurposeTo investigate the association between age-related macular degeneration (AMD) and 10-year all-cause and cause-specific mortality using a large-scale population-based sample. MethodsData from the 2005-2008 cycles of the National Health and Nutrition Examination Survey were used to assess the risk of mortality in relation to AMD in a propensity score-matched cohort. AMD status was assessed by retinal images with the standardized grading scheme. Mortality data until 31st December 2015 were derived from mortality archives. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for survival. ResultsA total of 4691 participants were included. After a median follow-up of 8.42 (IQR: 7.58-9.67) years, 698 participants died. Participants with any AMD had an increased risk of all-cause mortality (HR, 2.02; 95% CI, 1.37-2.98). Similar results were observed for early (HR, 1.93; 95% CI, 1.31-2.85) and late AMD (HR, 4.29; 95% CI, 2.10-8.79). For cause-specific mortality, any (HR, 2.17; 95% CI, 1.39-3.39), early (HR, 2.18; 95% CI, 1.36-3.51), and late AMD (HR, 3.95; 95% CI, 1.65-9.46) were associated with significantly higher mortality due to causes other than cardiovascular disease (CVD) or cancer. Late AMD independently predicted a higher risk of CVD mortality (HR, 2.48; 95% CI, 1.32-4.65). ConclusionsThe current study showed that any, early, and late AMD were associated with increased risks of all-cause mortality and mortality due to causes other than CVD or cancer. In addition, we found that late AMD was associated with increased risks of CVD mortality. SynopsisLate macular degeneration independently predicted higher cardiovascular disease mortality. Any, early and late age-related macular degeneration were associated with higher all-cause mortality and mortality due to causes other than cardiovascular disease or cancer.