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F U L L T I T L E : Systemic Levels of C-Reactive Protein in Patients with Age-Related Macular Degeneration: A Systematic Review with Meta-Analyses.
P A Y W A L L E D S O U R C E : Mechanisms of Ageing and Development
Highlights
• Age-related macular degeneration is the most prevalent cause of irreversible vision loss in the developed world. Chronic low-grade inflammation has been investigated as a possible contributor because of its relationship to ageing and its role in the gap between chronological and biological aging.
• Our systematic review summarizes the result of 53 studies with 60,598 participants wherein levels of C-reactive protein, a well-established marker of systemic inflammation, was been compared between healthy individuals and patients with age-related macular degeneration.
• Our meta-analyses find a significant small-to-moderate increase in systemic C-reactive protein in patients with late and neovascular age-related macular degeneration, whereas no significant differences were observed among patients with only early stages of age-related macular degeneration.
Abstract
Ageing of the retina is associated with the gradual accumulation of basal deposits and the formation of drusen. However, in some individuals this process is exacerbated and causes development of age-related macular degeneration.
Late features of age-related macular degeneration include geographic atrophy of the neuroretina or choroidal neovascularization. Such changes lead to blurred vision, metamorphopsia, and scotoma, and is the leading cause of vision loss in developed countries. Chronic low-grade inflammation has been investigated because of its relationship to ageing and its role in the gap between chronological and biological ageing.
Here, we systematically reviewed studies investigating systemic C-reactive protein in patients with age-related macular degeneration. We identified 53 studies with 60,598 participants (10,392 patients and 38,901 controls). Our meta-analyses revealed that early age-related macular degeneration was not associated to systemic C-reactive protein (Cohen’s d = 0.03 [-0.04 to 0.10]; OR = 1.06 [0.93 to 1.20]; P = 0.39) whereas late age-related macular degeneration (Cohen’s d = 0.38 [0.24 to 0.51]; OR = 1.99 [1.55 to 2.52]; P < 0.0001), and neovascular age-related macular degeneration (Cohen’s d = 0.40 [0.24 to 0.56]; OR = 2.07 [1.55 to 2.76]; P < 0.0001) was associated with a small-to-moderate increase in systemic C-reactive protein.
Our review provides an overview of this extensively studied field, provide summary estimates that provide insight into when and to what extent systemic C-reactive protein is associated with age-related macular degeneration, and help in distinguishing the potentially reversible disease processes from that of irreversible retinal ageing.
Outline
1. Introduction
2. Methods
2.1. Study Design
2.2. Eligibility Criteria
2.3. Information Sources, Search Strategy, and Study Selection
2.4. Data collection and risk of bias assessment
2.5. Outcome measures
2.6. Data analysis and synthesis
3. Results
3.1. Study Selection
3.2. Study and Population Characteristics
3.3. Results of Individual Studies
3.4. Risk of Bias Within Studies
3.5. Results of Meta-Analyses and Risk of Bias Across Studies
3.5.1. Any AMD and CRP
3.5.2. Early AMD and CRP
3.5.3. Late AMD and CRP
3.5.4. Geographic atrophy secondary to AMD and CRP
3.5.5. Neovascular AMD and CRP
4. Discussion
4.1. Conclusion
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