Hypertension affects the treatment of wet age-related macular degeneration

Abstract

Purpose: Due to population ageing as well as the high prevalence of hypertension and age-related macular degeneration (AMD) in elderly individuals, and the relationship between hypertension and AMD is unclear. Our research aimed to investigate the association between hypertension, wet AMD (wAMD) and the treatment strategy of wAMD patients affected by hypertension.

Methods: Data of wAMD patients at Zhongshan Ophthalmic Center, Sun Yat-sen University, between 1 January 2002 and 30 June 2019, were extracted from the electronic healthcare information system. wAMD patients were divided into subgroups by hypertension status, age, sex, the need for vitrectomy surgery and the number of anti-VEGF drug intravitreal injections that these were divided in 1-3 vs. >3 (available time from 1 January 2012 to 30 June 2019).

Results: A total of 3096 wAMD patients (41.7% female, 58.3% male) with an age range of 50-96 years (68.7 (SD 9.42) years) were included. wAMD was significantly associated with hypertension (p < 0.001). After adjustment for sex and age, Cox regression model showed a significant association between hypertension in wAMD patients and the number of injections (RR = 1.31, 95% CI: 1.13-1.50, p < 0.001). There was no significant association between hypertension and the need for vitrectomy (p = 0.82).

Conclusions: wet AMD was associated with hypertension status, and after the regular series of three injections, wAMD patients with hypertension were more likely to receive anti-VEGF drug intravitreal injections than those without hypertension. These results may facilitate prospective research on the prevention of wAMD and contribute to the management of wAMD patients.

Keywords: anti-VEGF treatment; hypertension; vitrectomy; wet age-related macular degeneration.