GOUT AND RISK OF AGE-RELATED MACULAR DEGENERATION.

Abstract

To examine the association between gout and subsequent development and progression of age-related macular degeneration (AMD). In this retrospective cohort study, a multicenter health care research network was used to identify patients with an International Classification of Diseases, 10th Revision for idiopathic gout and a prescription for uric acid-lowering agent (Gout cohort) compared with a matched cohort of patients without a diagnosis of gout (Control cohort) for ophthalmic outcomes. Propensity score matching was applied to balance baseline demographics and health status between cohorts. Patients with gout had an increased risk of developing dry AMD (relative risk, 2.73, 95% confidence intervals, 2.30-3.25; P < 0.001), advanced dry AMD (relative risk, 2.64, 95% confidence intervals, 1.32-5.28; P < 0.001), wet AMD (relative risk, 2.48, 95% confidence intervals, 1.82-3.38; P < 0.001), and needing subsequent antivascular endothelial growth factor therapy (relative risk, 2.80, 95% confidence intervals, 2.14-3.67; P < 0.001) compared with those without gout at 5 years. Similar trends were observed among patients with early AMD and gout compared with those with early AMD without gout. In a national multicenter database, an increased risk of AMD development and progression to advanced disease stages was found among patient with gout compared with controls. Additional investigation into the mechanisms and effects of hyperuricemia are necessary to clarify these associations.