Pulmonary disease and age-related macular degeneration: the Beaver Dam Eye Study

To examine the association of pulmonary symptoms, disease, and function with the incidence of age-related macular degeneration (AMD).

Population-based cohort study of persons aged 43 to 86 years at baseline (N = 4926), of whom 3779 participated in 1 or more follow-up examinations.

Stereoscopic photographs of the macula were graded to determine the presence of AMD. Existence of emphysema, asthma, and respiratory symptoms was determined from subjects' medical history questionnaires; the peak expiratory flow rate was measured using a Mini-Wright Peak Flow Meter (Clement Clarke International, Harlow, England). Discrete logistic hazard and logistic regression models were used.

Incidence and progression of AMD.

While controlling for age, sex, and other factors, a history of emphysema at baseline was found to be associated with the 15-year cumulative incidence of increased retinal pigment (odds ratio, 2.08; 95% confidence interval, 1.06-4.06), retinal pigment epithelium depigmentation (2.40; 1.23-4.67), and exudative AMD (3.65; 1.24-10.73). Mild pulmonary symptoms were associated with the 5-year incidence of exudative AMD (odds ratio, 3.83; 95% confidence interval, 1.39-10.58), and the fourth (ie, highest) quartile of pulmonary expiratory flow rate showed a protective effect for progression of AMD among women (0.36; 0.15-0.86).

Independent of smoking, a history of emphysema and respiratory symptoms and function are modestly but inconsistently associated with the incidence and progression of AMD.