Possible Association Between Dopamine Antagonists and Increased Conversion to Exudative Age-Related Macular...

Purpose: To investigate whether modulating dopamine signaling affects conversion to exudative age-related macular degeneration (AMD). Methods: A retrospective cohort study was performed using the Duke Epic database. Eyes from patients with a diagnosis of nonexudative AMD with at least 1 year of follow-up were evaluated for conversion to exudative AMD. Eyes with an AMD diagnosis were evaluated for age, sex, smoking history, hypertension, Age-Related Eye Disease Study (AREDS) or AREDS2 prescription, dopamine-modulating therapy prescription, and indication for dopamine-modulating therapy. Generalized estimating equations were used to calculate odds ratios for individual variables on conversion from nonexudative to exudative AMD. Results: Five hundred fifty-eight eyes of 354 patients with an initial diagnosis of nonexudative AMD were evaluated for conversion to exudative AMD. Conversion to exudative AMD was significantly higher in patients who had been on dopamine antagonist therapies for at least 3 years than in patients who were not on any dopamine-modulating therapies. After controlling for other variables, dopamine antagonists were associated with an increased risk for conversion to exudative AMD at 3 years of follow-up (P = .005). Conclusions: These findings suggest that antagonizing dopamine signaling may be associated with the development of macular neovascularization in eyes with nonexudative AMD. Although the data are observational, these findings warrant further investigation of dopamine signaling in conversion to exudative AMD.