国际眼科病理学杂志

A Clinical Analysis of Age-Related Macular Degeneration in Qinghai Plateau

Aiqin Zhu, Ling Li, Xin Zhong, Guofeng Li, Yinlan Li, Xiangxi Guo, Junming Lou, Zhenghong Qing, Shengzheng Wu and Jun Zhang

Aim: To investigate the clinically estimated incidence and risk factors for age-related macular degeneration (AMD) in a various nationalities in Tibet and Qinghai plateau.
Methods: 185 AMD patients (288 eyes), aged 40 to 86 years and lived in Qinghai-Tibet plateau area (with a sea-level of 1800 m - 4300 m), were enrolled. All patients were assigned into four groups based on their nationalities. The Detached Angiography, Optical Coherence Tomography (OCT), Fundus Photography, Visual Acuity, Slit-Lamp Examination, Intraocular Pressure, Laboratory Blood Test were employed.
Results: The data showed that the Qinghai region’s AMD patients in the 70 year old group are 43.25%, accounting for the largest proportion, while the 40 age group is 10.27%. AMD is significantly more prevalent in men than in women. In our 185 cases, the number of binocular cases is higher than that of the monocular. Dry AMD (56.25%) is higher than wet (43.75%). Blind and low vision patients constitute 9.03% and 28.47%, respectively. Vision loss in Tibetan patients is much higher than in Han patients (40.5% vs 28.6%). In the four different concentrations of hemoglobin, the 180 g/L group of AMD patients occupied 83 cases (44.86%). The vision damage is much more serious in exudative SMD than atrophic SMD determined by Fundus fluorescence angiography (FFA). The blood tests showed higher levels of triglycerides, red blood cells deposit, blood sugar, uric acid, and low density lipoprotein cholesterol (LDL-C) but lower levels of high density lipoprotein (HDL-C). Risk factors related to the plateau AMD may include: smoking, angiocardiopathy, hypertension, chronic obstructive pulmonary disease, and diabetes.
Conclusion: The chronic hypoxia environment may contribute to systemic changes of the body including retinal macular degeneration. Age, sex, smoking, particularly angiocardiopathy may be the main risk factors associated with AMD in the Qinghai-Tibetan Plateau.