Association between atrial fibrillation and age-related macular degeneration: A nationwide cohort study

Atrial fibrillation (AF) and age-related macular degeneration (AMD) are common debilitating conditions that share pathomechanisms involving chronic inflammation and oxidative stress. However, the association between AMD and AF, which is important for comprehending the pathogenesis, referral, and treatment strategies of these diseases, remains unknown.

This nationwide population-based retrospective cohort study used claims data from the National Health Insurance Research Database of Taiwan. From 1 January 2003 to 31 December 2018, an AF and AMD cohort of 34,236 and 31,766 patients, respectively, along with their matched control cohorts, were constructed using stabilised inverse probability of treatment weighting. The primary outcomes were the incidence of AMD following newly diagnosed AF and the incidence of AF following newly diagnosed AMD. A Cox regression model was used to estimate hazard ratios (HR) for these outcomes. Subgroup analysis based on AMD subtype and stratified analyses by age and sex were also conducted.

Compared with controls, patients with AF had a significantly increased risk of developing AMD (HR 1.10; 95% confidence interval [CI] 1.04-1.17). Similarly, patients with AMD had a significantly increased risk of developing AF (HR 1.08; 95%CI 1.02-1.15). Further subgroup analysis revealed a reciprocal association between AF and dry AMD. Age- and sex-stratified analyses demonstrated increasing risk trends for AF and AMD.

AF and AMD may share common underlying risk factors and pathophysiological mechanisms. Our findings identified a reciprocal association between AF and AMD. Further research is warranted to elucidate the pathophysiology of AF and AMD.