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AREDS Findings Suggest Cataract Surgery Not Associated with Progression to Neovascular AMD: Presented at the AAO

By Pippa Wysong

CHICAGO, IL -- October 26, 2005 -- Findings from the Age-Related Eye Disease Study (AREDS) Research Group contradict previous studies that suggested cataract surgery may be associated with an increased prevalence of age-related macular degeneration (AMD).

The differences between the various studies and whether there is a connection between AMD and cataracts "needs to be explained," said Frederick Ferris III, MD, Clinical Director, Epidemiology and Clinical Research, National Eye Institute, Bethesda, Maryland, United States.

Dr. Ferris spoke here on October 18^th at the annual meeting of the American Academy of Ophthalmology (AAO).

AREDS is an 11-center, double-masked clinical study that was designed to evaluate the clinical course and progression of AMD and cataracts. More than 4700 people were enrolled and were randomized to groups given either high-dose antioxidant vitamins and minerals, or placebo. Severity of disease among study participants ranged from early AMD to advanced AMD or vision loss in one eye due to AMD.

Patients in the study underwent both annual clinical examination and fundus photography to evaluate the development of advanced AMD.

"This study provides a unique opportunity to evaluate the effect of cataract surgery on the development of advanced AMD in patients who have regular retinal examinations by a retinal specialist," Dr. Ferris said.

At baseline, the median age of patients was 70 years, 55% were female. At the time of the presentation, the median follow-up of patients was about 6 years. Close to 73% of eyes had not progressed to either AMD nor did they require cataract surgery. Another 19% of eyes had undergone cataract surgery only, while 5% progressed to AMD only, and 2% of eyes had both.

"Cataract surgery did not significantly accelerate or was not associated with progression to neovascular AMD," Dr. Ferris said.

A feature of AREDS was that patients were regularly evaluated by a retinal specialist. "Without such examinations, it may be that in a general ophthalmology setting, decreased vision from early AMD may increase the risk of cataract extraction, rather than cataract extraction increasing the risk of developing advanced AMD," he said.


[Presentation title: Controversy of Cataract Extraction and AMD Progression. Session title: Retina Sub-specialty Day.]

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