Thyroid dysfunction and exudative age‐related macular degeneration – A longitudinal nationwide registry‐based cohort study

• Published in: Acta ophthalmologica (Oxford, England) Vol. 102; no. 7; pp. 813 - 820
• Main Authors: Boulakh, Lena, Isaksen, Jonas L., Poulsen, Henrik Enghusen, Faber, Jens, Heegaard, Steffen, Nygaard, Birte, Kanters, Jørgen Kim, Toft, Peter Bjerre, Mortens Udholm, Patricia, Bek, Toke, Buch Hesgaard, Helena, Ellervik, Christina
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.11.2024
• Subjects: Aged; Aged, 80 and over; AMD; Cohort analysis; Denmark - epidemiology; exudative AMD; Female; Follow-Up Studies; Humans; Hyperthyroidism; Hyperthyroidism - complications; Hyperthyroidism - diagnosis; Hyperthyroidism - drug therapy; Hyperthyroidism - epidemiology; Hypothyroidism; Hypothyroidism - complications; Hypothyroidism - diagnosis; Hypothyroidism - epidemiology; Incidence; Macular degeneration; Male; Middle Aged; Oftalmologi; Ophthalmology; Patients; Population studies; Public health; Registries; Retrospective Studies; Risk Factors; systemic disease; thyroid disease; Thyroid diseases; thyroid dysfunction; Thyroid gland; Thyroid hormones; Vascular endothelial growth factor; Wet Macular Degeneration - diagnosis; Wet Macular Degeneration - drug therapy; Wet Macular Degeneration - epidemiology; Wet Macular Degeneration - physiopathology; Denmark; thyroid disease; hyperthyroidism; hypothyroidism; exudative AMD; AMD; systemic disease; thyroid dysfunction
• ISSN: 1755-375X; 1755-3768; 1755-3768
• DOI: 10.1111/aos.16705

Purpose The association between thyroid dysfunction and exudative age‐related macular degeneration (AMD) is unknown. Methods In this Danish longitudinal nationwide registry‐based cohort study we included all Danish residents aged 50–100 between 2008 and 2018. Using the Danish national registries, we studied the association between thyroid dysfunction and exudative AMD. Thyroid dysfunction was classified as two consecutive redeemed prescriptions of thyroid hormones (hypothyroidism) or anti‐thyroid medication (hyperthyroidism). Exudative AMD was classified as an ICD diagnosis of AMD and a code for anti‐VEGF treatment. All patients are treated for exudative AMD in a hospital in Denmark, and we therefore have complete registration of this patient group. Results We included 2 087 305 individuals, of which 1 072 567 (51.4%) were women; 59 318 (2.8%) had hypothyroidism, and 33 922 (1.6%) had hyperthyroidism. During a median follow‐up of 11 years, 26 998 (1.3%) people developed exudative AMD. Hypothyroidism (adjusted hazard ratio [HR]: 1.17; 95% confidence interval [CI] 1.10–1.25; p < 0.001) and hyperthyroidism (HR: 1.23; 95% CI:1.13–1.34; p < 0.001) were both associated with the development of exudative AMD. The age‐stratified analyses yielded similar results to the main analyses, except that the risks were exaggerated in the older part of the population. Conclusion This is the first longitudinal nationwide study showing that both hypo‐ and hyperthyroidism are associated with an increased risk of exudative AMD. AMD is a quantitative problem in the population and our findings could have a public health impact. Further studies are needed to study the underlying mechanisms of the association.