Psoriasis Increase Neovascular Age-related Macular Degeneration Risk in Diabetic Patients: Study
A recent nationwide population-based study uncovered a significant link between psoriasis and an increased risk of developing neovascular Age-related Macular Degeneration (AMD) among individuals with type 2 diabetes mellitus (DM). This finding published in the American Journal of Ophthalmology adds to the growing body of evidence indicating that psoriasis may have far-reaching implications beyond the skin, particularly in patients with coexisting diabetes.
The retrospective cohort study analyzed data from over 2 million patients diagnosed with type 2 diabetes mellitus who were over the age of 40 between January 2009 and December 2012. The study evaluated whether psoriasis could be an independent risk factor for developing neovascular AMD characterized by the abnormal growth of blood vessels in the macula, the central part of the retina.
The patients were followed from their initial diagnosis until December 2018, with their medical records being examined for the incidence of neovascular AMD. The study cohort was divided into 2 groups, where 20,853 patients had been diagnosed of psoriasis and the other 2,224,505 individuals without psoriasis were the control group.
The results found that 105 cases of neovascular AMD were identified in the psoriasis group when compared to 7,459 cases in the control group. When adjusted for multiple variables including age, sex, BMI, lifestyle factors (such as smoking, drinking, and exercise habits), and other health conditions (such as hypertension, dyslipidemia, and diabetic retinopathy), the data revealed that individuals with psoriasis had a 32.9% higher risk of developing neovascular AMD when compared to the individuals without psoriasis. This finding was statistically significant, with a hazard ratio (HR) of 1.329 and a 95% confidence interval ranging from 1.096 to 1.612.
The findings of this study illuminate the importance of heightened caution among healthcare providers treating patients with both type 2 diabetes and psoriasis. Given the increased risk of neovascular AMD, it is crucial for clinicians to consider regular ophthalmologic screenings for this patient population, even in the absence of ocular symptoms.
The association between psoriasis and neovascular AMD highlights the need for further research into the underlying mechanisms linking these conditions. Chronic inflammation of psoriasis may play a key role in the pathogenesis of neovascular AMD, particularly in the context of diabetes, which is itself associated with microvascular complications.
Overall, this study emphasizes the importance of a multidisciplinary approach in managing patients with complex comorbidities like diabetes and psoriasis. Early detection and proactive management of neovascular AMD could potentially prevent significant vision loss in this vulnerable population.
Reference:
Lee, M. Y., Han, K., Min, K. H., Yu, D. S., & Lee, Y. B. (2024). Psoriasis as a Predictor of Neovascular Age-Related Macular Degeneration in Type 2 Diabetes Mellitus: A Nationwide Cohort Study. In American Journal of Ophthalmology. Elsevier BV. https://doi.org/10.1016/j.ajo.2024.08.033
