Yoon Je Moon, Lim Dong Hui, Youn Jinyoung, Han Kyungdo, Kim Bong Sung, Jung Wonyoung, Yeo Yohwan, Shin Dong Wook, Ham Don-Il
Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea.
Eur J Neurol. 2023 Sep;30(9):2641-2649. doi: 10.1111/ene.15896. Epub 2023 Jun 4.
The association between Parkinson's disease (PD) and age-related macular degeneration (AMD) has been shown in previous reports. However, the association between the severity of AMD and PD development is unknown. The aim was to evaluate the association of AMD with/without visual disability (VD) with the risk of PD occurrence using the National Health Insurance data in South Korea.
A total of 4,205,520 individuals, 50 years or older and without a previous diagnosis of PD, participated in the Korean National Health Screening Program in 2009. AMD was verified using diagnostic codes, and participants with VD were defined as those with loss of vision or visual field defect as certified by the Korean Government. The participants were followed up until 31 December 2019, and incident cases of PD were identified using registered diagnostic codes. The hazard ratio was calculated for groups (control and AMD with/without VD) using multivariable adjusted Cox regression analysis.
In total, 37,507 participants (0.89%) were diagnosed with PD. Amongst individuals with AMD, the risk of PD development was higher in individuals with VD (adjusted hazard ratio [aHR] 1.35, 95% confidence interval [CI] 1.09-1.67) than in those without (aHR 1.22, 95% CI 1.15-1.30) compared with controls. Additionally, an increased risk of PD was observed in individuals with AMD compared with controls, regardless of the presence of VD (aHR 1.23, 95% CI 1.16-1.31).
Visual disability in AMD was associated with the development of PD. This suggests that neurodegeneration in PD and AMD may have common pathways.
既往报告显示帕金森病(PD)与年龄相关性黄斑变性(AMD)之间存在关联。然而,AMD的严重程度与PD发病之间的关联尚不清楚。本研究旨在利用韩国国民健康保险数据评估有无视力障碍(VD)的AMD与PD发生风险之间的关联。
2009年,共有4205520名50岁及以上且既往未诊断为PD的个体参加了韩国国民健康筛查项目。使用诊断编码核实AMD情况,VD参与者定义为经韩国政府认证有视力丧失或视野缺损的人。对参与者随访至2019年12月31日,通过登记的诊断编码确定PD的新发病例。采用多变量校正Cox回归分析计算各组(对照组以及有/无VD的AMD组)的风险比。
共有37507名参与者(0.89%)被诊断为PD。在AMD患者中,与对照组相比,有VD的患者发生PD的风险更高(校正风险比[aHR]1.35,95%置信区间[CI]1.09 - 1.67),而无VD的患者发生PD的风险相对较低(aHR 1.22,95% CI 1.15 - 1.30)。此外,与对照组相比,无论有无VD,AMD患者发生PD的风险均增加(aHR 1.23,95% CI 1.16 - 1.31)。
AMD中的视力障碍与PD的发生有关。这表明PD和AMD中的神经退行性变可能有共同的途径。