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Circulating Inflammatory Markers and Hemostatic Factors in Age-Related Maculopathy: A Population-Based Case–Control Study

¹From the Center for Vision Research, Department of Ophthalmology, University of Sydney, Westmead Hospital, Westmead, NSW, Australia; the ²Department of Hematology, Institute of Clinical Pathology and Medical Research (ICPMR), Westmead Hospital, Westmead, NSW, Australia; and the ³Department of Clinical Immunology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.

PURPOSE. To examine the relationship between circulating inflammatory markers, hemostatic factors, and age-related maculopathy (ARM).

METHODS. A population-based, cross-sectional case–control study drawn from the Blue Mountains Eye Study included 159 early and 38 late ARM cases, and 433 controls matched for age, gender, and smoking. ARM lesions were assessed from retinal photographs according to the Wisconsin ARM grading system. Circulating inflammatory markers (high-sensitivity C-reactive protein [hsCRP], intercellular adhesion molecule [ICAM]-1, and interleukin [IL]-6), white cell count (WCC), and hemostatic factors (fibrinogen, homocysteine, plasminogen activator inhibitor [PAI]-1 and von Willebrand factor [vWF]) were assessed. Age, gender, current smoking, body mass index, hypertension, history of stroke, and cardiovascular events were adjusted for. Adjusted mean levels of each marker were compared between persons with early ARM, those with late ARM, and control subjects, and are presented as probabilities. Adjusted associations with ARM were examined continuously (per SD), and are presented as odds ratios (ORs) and 95% confidence intervals (CIs). Summarizing z scores for inflammation and hemostatic dysfunction were calculated.

RESULTS. Increased PAI-1 level was associated with both early (OR 1.2, 95% CI 1.0–1.4 per SD increase) and late ARM (OR 1.3, 95% CI 0.9–1.9 per SD increase). Elevated ICAM-1 level was marginally associated with late ARM (OR 1.3, 95% CI 1.0–1.7 per SD increase). No other significant associations were found between the remaining inflammatory or hemostatic markers and either early or late ARM. Summarized z scores for inflammatory or hemostatic markers also did not suggest any associations.

CONCLUSIONS. There was no consistent pattern of association found between ARM and circulating inflammatory markers or hemostatic factors in this population-based case–control study.

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