Prospective Study of Plasma Homocysteine Level and Risk of Age-Related Macular Degeneration in Women

ABSTRACT

Purpose: Prospective data to examine the association of homocysteine with age-related macular degeneration (AMD) are limited. We examined the prospective relation of plasma homocysteine level and AMD in a large cohort of apparently healthy women.

Methods: We evaluated the relationship between baseline levels of plasma homocysteine and incident AMD among 27,479 female health professionals aged 40 years or older. Main outcome measures were total AMD, defined as self-report documented by medical record evidence of an initial diagnosis after randomization, and visually significant AMD, defined as confirmed incident AMD with visual acuity 20/30 or worse attributable to this condition.

Results: During an average 10 years of follow-up, a total of 452 cases of AMD, including 182 cases of visually significant AMD, were documented. Women in the highest versus lowest quartile of plasma homocysteine had modestly, but statistically non-significant, increased risks of total AMD (hazard ratio, HR, 1.24, 95% confidence interval, CI, 0.95–1.63; p for trend 0.07) and visually significant AMD (HR 1.41, 95% CI 0.92–2.17; p for trend 0.052) in age- and treatment-adjusted analyses.

Conclusions: These prospective data from a large cohort of apparently healthy women do not support a strong role for homocysteine in AMD occurrence.

• Age-related macular degeneration
• homocysteine
• prospective cohort
• risk factor
• Women's Health Study

DECLARATION OF INTEREST

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

Dr. Christen had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analyses.

Financial Disclosures: W.G.C. investigator-initiated research funding from the National Institutes of Health, Harvard University (Clinical Nutrition Research Center), and DSM Nutritional Products Inc. (formerly Roche Vitamins). N.R.C. investigator-initiated research funding from the National Institutes of Health. P.M.R. investigator-initiated research funding from the National Institutes of Health. J.E.B. investigator-initiated research funding from the National Institutes of Health and assistance with study pills and packaging from Natural Source Vitamin E Association and Bayer Healthcare for the Women's Health Study.

This study was supported by Grants EY 06633, EY 18820, HL 43851, HL 58755, and CA 47988 from the National Institutes of Health (Bethesda, MD) and the Donald W. Reynolds Foundation, Las Vegas, NV. The National Institutes of Health and the Donald W. Reynolds Foundation had no role in the design or conduct of this research.