Study Reveals Association Between Cardiac Arrhythmias and Macular Degeneration Risk

Significant cardiovascular conditions, such as myocardial infarction, cardiac valve disease, and ischemic stroke, have been linked to age-related macular degeneration and subretinal drusenoid deposits (SDDs). In light of this, R. Theodore Smith, M.D., Ph.D., of the Icahn School of Medicine at Mount Sinai, and colleagues examined the relationship between cardiac arrhythmias and SDDs and the impact of heart failure on cardiac index (CI). 

For this purpose, the researchers conducted a study involving 55 cardiac patients aged 49 to 91 at Mount Sinai Hospital. The patients underwent spectral domain optical coherence tomography scans to assess the presence of subretinal drusenoid deposits. Patient charts were then reviewed for cardiac index and arrhythmias.

The following were the key findings of the study:

• Cardiac arrhythmias may contribute to developing subretinal drusenoid deposits through ocular hypoperfusion. Among the 30 patients with arrhythmias, 15 were found to have SDDs, compared to only five out of 25 patients without arrhythmias.
• The mean cardiac index was significantly lower in patients with SDDs (1.95 ± 0.60 L/min/m²) than those without (2.71 ± 0.73 L/min/m²).

"Patients with common arrhythmias, such as atrial fibrillation, or those with serious cardiovascular conditions like myocardial infarction and stroke should undergo immediate optical coherence tomography of the macula to check for subretinal drusenoid deposits. If SDDs are detected, a retinal referral is warranted," Smith stated to Elsevier’s PracticeUpdate.

He continued, "A large cohort of age-related macular degeneration patients with SDDs and/or typical drusen should be evaluated for cardiovascular disease through electrocardiograms to check for arrhythmias, as well as cardiac and carotid ultrasound tests for other serious vascular issues. This approach will clarify the true risk associated with SDDs compared to drusen regarding CVD and help identify previously undetected cardiovascular problems, particularly among Black, Hispanic, and female populations, where underdiagnosed CVD is a significant public health concern."

"Cardiac arrhythmias, such as atrial fibrillation, are linked to subretinal drusenoid deposits in age-related macular degeneration. These arrhythmias can lead to heart failure by disrupting the relationship between ventricular output and filling, potentially contributing to SDDs through ocular hypoperfusion. The observed decrease in cardiac index in patients with SDDs supports this mechanism. Furthermore, SDDs may serve as a biomarker for serious heart disease, highlighting a critical concern for underserved populations and women," the researchers concluded.

Reference: https://aao.apprisor.org/apsSession.cfm