The aociation of prior cytomegaloviru infection with neovacular age-related macular degeneration

Purpoe To determine if prior expoure to pathogen aociated with vacular dieae, cytomegaloviru, Chlamydia pneumoniae, and Helicobacter pylori correlate with neovacular age-related macular degeneration (AMD). Deign An experimental tudy. Method etting Intitutional. Bacom Palmer Eye Intitute, October 2001 to December 2002. Patient population 150 patient (47 neovacular amd, 36 dry amd, and 67 non-amd control) were included in the tudy. excluion criteria included hiv infection, malignancy, recent acute illne requiring hopitalization within 6 month, or immunouppreive illne. Procedure erum ample were obtained for analyi of cytomegaloviru, chlamydia pneumoniae, and helicobacter pylori igg antibody titer by elia. Main outcome meaure Comparion of the ditribution of igg titer between patient with wet amd, dry amd, and control. Reult The average cytomegaloviru IgG titer wa higher in patient with wet AMD veru control (p = 0.02, tudent t-tet, two-tailed) and patient with dry AMD (p = 0.06). Twenty-ix (55%) of 47 ubject with wet AMD had high cytomegaloviru IgG titer compared with 14 (39%) of 36 patient with dry AMD (odd ratio [OR] = 2.23, 95% confidence interval [CI] = 0.77 to 6.44) and 23 (34%) of 67 control patient (OR = 2.49, 95% CI = 0.98 to 6.33). There wa no major difference in the ditribution of titer for Chlamydia pneumoniae IgG and Helicobacter pylori IgG in wet and dry AMD patient. Five of 47 patient with wet AMD (11%) had high antibody titer to all three pathogen, compared with only 1 of 36 patient with dry AMD (3%) (OR = 4.17, 95% CI = 0.46 to 37.36). Concluion There wa a ignificant aociation of high cytomegaloviru IgG titer with neovacular AMD compared with dry AMD and control patient. Chronic infection with cytomegaloviru may be a novel rik factor for the progreion from dry to neovacular AMD.