Journal of The Korean Ophthalmological Society (대한안과학회지)

The Korean Ophthalmological Society (대한안과학회)
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Usefulness of Brachial-Ankle Pulse Wave Velocity and Ankle-Brachial Index as Predictors of Early Age-Related Maculopathy

맥파 속도와 상완-발목 지수의 조기연령관련 황반변성 예측인자로서의 유용성

  • Jang, Jung-Hyun (Department of Ophthalmology, Maryknoll Medical Center) ;
  • Park, Jung-Min (Department of Ophthalmology, Maryknoll Medical Center) ;
  • Kim, Sang-Soo (Department of Ophthalmology, Maryknoll Medical Center)
  • Published : 2011.06.15
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Abstract

Purpose: Age-related maculopathy (ARM) is a major cause of blindness. For this reason, an early predictor of ARM is necessary for early detection and preventive therapy. The present study investigated arterial stiffness and stenosis using ankle brachial index (ABI) and pulse wave velocity (PWV) and analyzed whether arterial stiffness was affected by the extent of ARM. Methods: A total of 257 randomized patients were enrolled in the present study. All participants underwent baPWV, ABI, blood pressure, total cholesterol, and triglyceride evaluation and were questioned regarding their history of smoking. The extent of ARM was expressed using Wisconsin ARM grading. Results: Of the 257 patients, 29 were diagnosed with early ARM using Wisconsin ARM grading. The average age of the ARM group was 53 ${\pm}$ 6.56 years and was significantly greater than the average 45.93 ${\pm}$ 8.61 years in the non-ARM group. Other than ankle-brachial index, the clinical variables showed no significant differences after a refining process for age-related variables. Ankle-brachial index was significantly lower in the ARM group than it was in the non-ARM group (1.08 ${\pm}$ 0.052, 1.12 ${\pm}$ 0.051, respectively). Conclusions: The ARM group showed significantly increased arterial stenosis. The present study provides a basis for the use of PWV in the early detection of ARM; however, longitudinal studies employing a larger population are required to determine the diagnostic and prognostic implications of PWV in ARM.

목적: 본 연구는 맥파 속도 및 상완-발목 지수를 측정함으로써 말초혈관의 경직도를 평가하고 조기연령관련 황반변성에 대한 예측인자로서의 유용성에 대해 분석하고자 한다. 대상과 방법: 257명을 대상으로 상완 발목 맥파 속도 및 상완-발목 지수, 수축기 및 이완기혈압, 혈당, 총콜레스테롤, 저밀도콜레스테롤, 고밀도콜레스테롤, 트리글리세라이드, 체질량지수, 흡연력을 조사하고 위스콘신 연령관련 황반변성등급을 통해 진단한 조기연령관련 황반변성군과의 관련성을 평가하였다. 결과: 연령에 대한 혼란변수를 통제하여 125명을 분석하였을 때, 양측 상완-발목 지수 평균은 조기연령관련 황반변성군에서 1.08 ${\pm}$ 0.052로 정상군 1.12 ${\pm}$ 0.051에 비해 통계적으로 유의하게 낮았다(p=0.042). 나머지 인자들에 대해서는 통계학적으로 유의한 결과를 보이지 않았다. 결론: 연령과 같은 다른 관련 인자에 의한 편의를 통제하였을 때, 맥파 속도를 통한 상완-발목 지수가 조기연령관련 황반변성의 효과적인 예측인자가 될 수 있으며, 측정 방법이 쉽고 간편하여 대규모 선별검사에서 임상적 이용이 유용할 것으로 생각한다.

Keywords

References

  1. Fine SL, Berger JW, Maguire MG, Ho AC. Age-related macular degeneration. N Engl J Med 2000;342:483-92. https://doi.org/10.1056/NEJM200002173420707
  2. Friedman E. Update of the vascular model of AMD. Br J Ophthalmol 2004;88:161-3. https://doi.org/10.1136/bjo.2003.036277
  3. Friedman E. The role of the atherosclerotic process in the pathogenesis of age-related macular degeneration. Am J Ophthalmol 2000;130:656-63.
  4. Pauleikhoff D, Chen JC, Chisholm IH, Bird AC. Choroidal perfusion abnormality with age-related Bruch's membrane change. Am J Ophthalmol 1990;109:211-7.
  5. Metelitsina TI, Grunwald JE, DuPont JC, Ying GS. Effect of systemic hypertension on foveolar choroidal blood flow in age related macular degeneration. Br J Ophthalmol 2006;90:342-6. https://doi.org/10.1136/bjo.2005.082974
  6. Klein R, Klein BE, Marino EK, et al. Early age-related maculopathy in the cardiovascular health study. Ophthalmology 2003;110: 25-33. https://doi.org/10.1016/S0161-6420(02)01565-8
  7. Moss SE, Klein R, Klein BE. Ankle-brachial index and the prevalence of age-related maculopathy. Am J Ophthalmol 2005;140: 1159-61. https://doi.org/10.1016/j.ajo.2005.07.029
  8. Klein R, Klein BE, Tomany SC, Cruickshanks KJ. The association of cardiovascular disease with the long-term incidence of agerelated maculopathy: the Beaver Dam Eye Study. Ophthalmology 2003;110:1273-80. https://doi.org/10.1016/S0161-6420(03)00599-2
  9. van Leeuwen R, Ikram MK, Vingerling JR, et al. Blood pressure, atherosclerosis, and the incidence of age-related maculopathy: the Rotterdam Study. Invest Ophthalmol Vis Sci 2003;44:3771-7. https://doi.org/10.1167/iovs.03-0121
  10. Vingerling JR, Dielemans I, Bots ML, et al. Age-related macular degeneration is associated with atherosclerosis. The Rotterdam Study. Am J Epidemiol 1995;142:404-9.
  11. Cheung N, Liao D, Islam FM, et al. Is early age-related macular degeneration related to carotid artery stiffness? The Atherosclerosis Risk in Communities Study. Br J Ophthalmol 2007;91:430-3. https://doi.org/10.1136/bjo.2006.106054
  12. Klein R, Clegg L, Cooper LS, et al. Prevalence of age-related maculopathy in the Atherosclerosis Risk in Communities Study. Arch Ophthalmol 1999;117:1203-10. https://doi.org/10.1001/archopht.117.9.1203
  13. Klein R, Davis MD, Magli YL, et al. The Wisconsin age-related maculopathy grading system. Ophthalmology 1991;98:1128-34.
  14. Zheng ZJ, Sharrett AR, Chambless LE, et al. Associations of ankle- brachial index with clinical coronary heart disease, stroke and preclinical carotid and popliteal atherosclerosis: the Atherosclerosis Risk in Communities (ARIC) Study. Atherosclerosis 1997;131: 115-25. https://doi.org/10.1016/S0021-9150(97)06089-9
  15. Rachapalli SM, Kiely PD, Bourke BE. Prevalence of abnormal ankle brachial index in patients with primary Sjogren's syndrome. Clin Rheumatol 2009;28:587-90. https://doi.org/10.1007/s10067-009-1099-x
  16. Muro Y, Sugiura K, Morita Y, Tomita Y. An evaluation of the efficacy of the toe brachial index measuring vascular involvement in systemic sclerosis and other connective tissue diseases. Clin Exp Rheumatol 2009;27:26-31.
  17. van Popele NM, Grobbee DE, Bots ML, et al. Association between arterial stiffness and atherosclerosis: the Rotterdam Study. Stroke 2001;32:454-60. https://doi.org/10.1161/01.STR.32.2.454
  18. Yamashina A, Tomiyama H, Takeda K, et al. Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 2002;25:359-64. https://doi.org/10.1291/hypres.25.359
  19. Cortez-Cooper MY, Supak JA, Tanaka H. A new device for automatic measurements of arterial stiffness and ankle-brachial index. Am J Cardiol 2003;91:1519-22. https://doi.org/10.1016/S0002-9149(03)00416-8

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