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AMD and stroke
Submit responseTo the Editor, Wong and colleagues concluded that age-related macular degeneration (AMD) is an independent risk factor for stroke (1). However, some information is missing.
Although the authors demonstrated that stroke-free survival rate in persons with early-stage AMD was higher than in those without early-stage AMD, they did not mention that the difference in such survival rate is statistically significant. In spite of 10 years follow-up, such survival rate difference shown in their report seems to be very small (1), suggesting that AMD seems not to be worth a predicting factor for clinical practices.
The authors did not provide information about serum levels of inflammatory biomarkers. Higher level of C-reactive protein (CRP) is independently associated with progression of AMD (2). CRP is also one of risk factors for ischemic stroke, independent of potential confounders (3). The analysis of inflammation states in eligible persons could affect the association between AMD and stroke.
References
(1) Wong TY, Klein R, Sun C, et al. Age-related macular degeneration and risk for stroke. Ann Intern Med 2006;145:98-106.
(2) Seddon JM, George S, Rosner B, et al. Progression of age-related macular degeneration: prospective assessment of C-reactive protein, interleukin 6, and other cardiovascular biomarkers. Arch Ophthalmol 2005;123:774-82.
(3) Woodward M, Lowe GD, Campbell DJ, et al. Associations of inflammatory and hemostatic variables with the risk of recurrent stroke. Stroke 2005;36:2143-7.
Conflict of Interest:
None declared