Original articleThe association of prior cytomegalovirus infection with neovascular age-related macular degeneration☆
Section snippets
Methods
The study was conducted with the prior approval of the institutional review board of the University of Miami School of Medicine. One hundred and fifty patients aged 50 to 90 years old, who were examined at the Bascom Palmer Eye Institute or the Bascom Palmer Palm Beach Clinic from October 2001 through December 2002, were enrolled in the study. Patients underwent a complete ophthalmic examination, including fundus photography and fluorescein angiography if appropriate. Exclusion criteria
Results
The distribution of age, male or female sex, smoking history, and vitamin usage according to the Age-Related Eye Disease Study (AREDS) is shown in Table 1. The prevalence of several potential risk factors did not differ between the wet and dry AMD groups, including age, male or female sex, smoking history, and AREDS vitamin usage. However, the control population was slightly younger than the AMD population.
Serum was collected from 67 control subjects, 36 patients with dry AMD, and 47 patients
Discussion
We analyzed the levels of IgG specific for CMV, C. pneumoniae, and H. pylori in patients with dry and neovascular AMD. These data reveal a significant association between high CMV-specific IgG titer and neovascular AMD compared with patients with dry AMD. We did not observe a statistically significant difference in the levels of IgG specific for C. pneumoniae and H. pylori. Moreover, there was no significant difference in the baseline characteristics of the dry and wet AMD populations in
Supplementary files
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2021, Progress in Retinal and Eye ResearchCitation Excerpt :While primary infection causes little to no symptoms in most people, it is frequently followed by establishment of persistent or latent infection, including in myeloid lineage cells and monocytes that give rise to activated macrophage cell populations in tissues (Hahn et al., 1998; Sweet, 1999). We assessed CMV IgG titers in a case-control study of dry AMD patients, NVAMD patients, and age-matched control subjects without AMD and found that highest titers of CMV IgG were significantly associated with NVAMD, as compared to dry AMD and controls, suggesting increased risk of NVAMD in patients with latent CMV infection (Miller et al., 2004). To understand the role of latent CMV infection in CNV pathobiology, we assessed the effects of latent murine CMV (MCMV) in 7–8 month old mice in the laser-induced CNV model and found that mice with latent MCMV infection exhibited larger CNV lesions with arteriolarization and fibrosis, as compared to control mice receiving UV-inactivated MCMV exposed control mice that had small capillary CNV (Cousins et al., 2012) (Fig. 14).
A Proinflammatory Function of Toll-Like Receptor 2 in the Retinal Pigment Epithelium as a Novel Target for Reducing Choroidal Neovascularization in Age-Related Macular Degeneration
2017, American Journal of PathologyCitation Excerpt :This two-step process would trigger hyperactivation of the TLR2 and chronic RPE-mediated inflammation, resulting in tissue damage, subsequent up-regulation of VEGFA, including by the RPE and recruited macrophages, and eventual neovascularization. In support of this concept, C. pneumoniae antigen has been detected in clinical samples of CNV membranes, and human cytomegalovirus infection has been associated with wet AMD.38,50,51 If this mechanism is responsible for even a portion of CNV pathogenesis, treating patients with broad-spectrum antibiotics and/or antiviral drugs to suppress infection at the RPE could inhibit the development of CNV and represent a novel means of reducing the incidence and/or progression of CNV.
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2015, Infection and AutoimmunitySystemic and ocular fluid compounds as potential biomarkers in age-related macular degeneration
2018, Survey of OphthalmologyCitation Excerpt :Another infectious agent possibly involved in the pathogenesis of AMD is Helicobacter pylori. Two studies have tested an association between antibodies against Helicobacter pylori and AMD but found no evidence for this, even when distinguishing between dry and neovascular AMD.188,227 To summarize the most important findings regarding immune-related factors, involvement of the complement system in AMD is evident and complement activation products seem to be good biomarker candidates.
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