Enfermedad de Alzheimer y degeneración macular asociada a la edad

  1. H.M. Roca-Santiago
  2. J.R. Lago-Bouza
  3. J.C. Millán-Calenti
  4. F. Gómez-Ulla-Irazazábal
Revista:
Archivos de la Sociedad Española de Oftalmologia

ISSN: 0365-6691

Año de publicación: 2006

Volumen: 81

Número: 2

Páginas: 73-78

Tipo: Artículo

DOI: 10.4321/S0365-66912006000200006 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Archivos de la Sociedad Española de Oftalmologia

Objetivos de desarrollo sostenible

Resumen

Objetivos: Analizar diferentes factores de riesgo implicados en la aparición de la enfermedad de Alzheimer y de la degeneración macular asociada a la edad, tratando de establecer una relación de asociación entre ambas entidades. Métodos: Sobre una muestra de 57 sujetos, de los que 33 presentan demencia (casos) y 24 no (controles) se realiza estudio analítico a fin de establecer el grado de asociación entre la enfermedad de Alzheimer (EA) y la degeneración macular asociada a la edad (DMAE). Para ello, tras realizar anamnesis a todos los sujetos, se estudia el fondo de ojo mediante cámara no midriática tipo Topcon TRV-50VT. Resultados: De acuerdo a la hipótesis de trabajo planteada, aplicada la razón de productos cruzados o de disparidad (odds ratio) se obtuvo un resultado positivo que determina relación causa efecto, ya que el porcentaje de casos con DMAE (42,4%) es superior al de controles con DMAE (25%). Por otro lado mediante la Chi cuadrado de Pearson, aunque no se establecieron diferencias significativas, los datos obtenidos muestran protección en el grupo control de acuerdo al estadístico exacto de Fisher (p=0,649). Conclusiones: Existen evidencias suficientes para pensar que la EA y la DMAE podrían tener factores etiológicos y patogénicos comunes, y aunque en nuestro estudio no hemos podido establecer la relación significativa entre ambas patologías, posiblemente en base al tamaño de la muestra o a las diferencias de edades entre ambos grupos, creemos establecida la posible asociación como para plantear un futuro trabajo que pueda confirmar estos hallazgos.

Referencias bibliográficas

  • Klein, R, Klein, BE, Linton, KL. (1992). Prevalence of age-related maculopathy: The Beaver Dam Eye Study. Ophthalmology. 99. 933-943
  • Klein, R, Klein, BE, Jensen, SC, Meuer, SM. (1997). The five-year incidence and progression of age-related maculopathy. Ophthalmology. 104. 7-21
  • Dentchev, T, Milam, AH, Lee, VM, Trojanowski, JQ, Dunaief, JL. (2003). Amyloid-beta is found in drusen from some age-related macular degeneration retinas, but not in drusen from normal retinas. Mol Vis. 9. 184-190
  • Vingerling, JR, Dielemans, I, Hofman, A, Grobbee, DE, Hijmering, M, Kramer, CF. (1995). The Prevalence of age-related maculopathy in the Rotterdam Study. Ophthalmology. 102. 205-210
  • Morris, JC, Storandt, M, McKeel, DW Jr, Rubin, EH, Price, JL, Grant, EA. (1996). Cerebral amyloid deposition and diffuse plaques in "normal" aging: Evidence for presymptomatic and very mild Alzheimer's disease. Neurology. 46. 707-719
  • Anderson, DH, Ozaki, S, Nealon, M, Neitz, J, Mullins, RF, Hageman, GS. (2001). Local cellular sources of apolipoprotein E in the human retina and retinal pigmented epithelium: implications for the process of drusen formation. Am J Ophthalmol. 131. 767-781
  • Corder, EH, Saunders, AM, Strittmatter, WJ, Schmechel, DE, Gaskell, PC, Small, GW. (1993). Gene dose of apolipoprotein e type 4 allele and the risk of Alzheimer's disease in late onset families. Science. 261. 921-923
  • Tang, MX, Stern, Y, Marder, K, Bell, K, Gurland, B, Lantigua, R. (1998). The APOE epsilon 4 allele and the risk of Alzheimer disease among African Americans, whites, and Hispanics. JAMA. 279. 751-755
  • Saunders, AM, Strittmatter, WJ, Schmechel, D, St George-Hyslop, PH, Pericak-Vance, MA, Joo, SH. (1993). Association of apolipoprotein E allele epsilon 4 with late-onset familial and sporadic Alzheimer´s disease. Neurology. 43. 1467-1472
  • McKhann, G, Drachman, D, Folstein, M, Katzman, R, Price, D, Stadlan, EM. (1984). Clinical diagnosis of Alzheimer´s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer´s Disease. Neurology. 34. 939-944
  • (2002). Manual diagnóstico y estadístico de los trastornos mentales: Versión española de la 4th edición, Texto Revisado (DSM-IV-TR).. Masson SA. Barcelona.
  • Bird, AC, Bressler, NM, Bressler, SB, Chisholm, IH, Coscas, G, Davis, MD. (1995). An international classification and grading system for age-related maculopathy and age-related macular degeneration: The International ARM Epidemiological Study Group. Surv Ophthalmol. 39. 367-374
  • Seddon, JM, Willett, WC, Speizer, FE, Hankinson, SE. (1996). A prospective study of cigarette smoking and age-related macular degeneration in women. JAMA. 276. 1141-1146
  • Klein, R, Klein, BE, Moss, SE. (1998). Relation of smoking to the incidence of age-related maculopathy: The Beaver Dam Eye Study. Am J Epidemiol. 147. 103-110
  • Ott, A, Slooter, AJ, Hofman, A, van Harskamp, F, Witteman, JC, Van Broeckhoven, C. (1998). Smoking and risk of dementia and Alzheimer's disease in a population-based cohort study: the Rotterdam Study. Lancet. 351. 1840-1843
  • Klaver, CC, Ott, A, Hofman, A, Assink, JJ, Breteler, MM, de Jong, PT. (1999). Is age-related maculopathy associated with Alzheimer's disease?: The Rotterdam Study. Am J Epidemiol. 150. 963-968
  • Blanks, JC, Torigoe, Y, Hinton, DR, Blanks, RH. (1991). Retinal degeneration in the macula of patients with Alzheimer's disease. Ann N Y Acad Sci. 640. 44-46
  • Johnson, LV, Leitner, WP, Rivest, AJ, Staples, MK, Radeke, MJ, Anderson, DH. (2002). The Alzheimer's: A beta-peptide is deposited at sites of complement activation in pathologic deposits associated with aging and age-related macular degeneration. Proc Natl Acad Sci USA. 99. 11830-11835
  • Anderson, DH, Mullins, RF, Hageman, GS, Johnson, LV. (2002). A role for local inflammation in the formation of drusen in the aging eye. Am J Ophthalmol. 134. 411-431
  • Hofman, A, Ott, A, Breteler, MM, Bots, ML, Slooter, AJ, van Harskamp, F. (1997). Atherosclerosis, apolipoprotein E, and prevalence of dementia and Alzheimer's disease in the Rotterdam Study. Lancet. 349. 151-154
  • Hyman, L, Schatat, AP, He, Q, Leske, MC. (2000). Hypertension, cardiovascular disease, and age-related macular degeneration. Arch Ophthalmol. 118. 351-358
  • Hirvela, H, Luukinen, H, Laara, E, Sc, L, Laatikainen, L. (1996). Risk factors of age-related maculopathy in a population 70 years of age or older. Ophthalmology. 103. 871-878
  • Vingerling, JR, Dielemans, I, Bots, ML, Hofman, A, Grobbee, DE, Jong, PTV. (1995). Age-related macular degeneration is associated with atherosclerosis: The Rotterdam Study. Am J Epidemiol. 142. 404-409
  • Pauleikhoff, D, Chen, JC, Chisholm, IH, Bird, AC. (1990). Choroidal perfusion abnormality with age-related Bruch's membrane change. Am J Ophthalmol. 109. 211-217
  • Ellis, RJ, Olichney, JM, Thal, LJ, Mirra, SS, Morris, JC, Beekly, D. (1996). Cerebral amyloid angiopathy in the brains of patients with Alzheimer's disease: the CERAD experience, Part XV. Neurology. 46. 1592-1596
  • Souied, EH, Benlian, P, Amouyel, P, Feingold, J, Lagarde, JP, Munnich, A. (1998). The epsilon 4 allele of the apolipoprotein e gene as a potential protective factor for exudative age-related macular degeneration. Am J Ophthalmol. 125. 353-359
  • Ott, A, Breteler, MM, van Harskamp, F, Stijnen, T, Hofman, A. (1998). Incidence and risk of dementia: The Rotterdam Study. Am J Epidemiol. 147. 574-580
  • Strittmatter, WJ, Saunders, AM, Schmechel, D, Pericak-Vance, M, Enghild, J, Salvesen, GS. (1993). Apolipoprotein E: high-avidity binding to beta-amyloid and increased frequency of type 4 allele in late-onset familial Alzheimer disease. Proc Natl Acad Sci USA. 90. 1977-1981
  • Tsai, MS, Tangalos, EG, Petersen, RC, Smith, GE, Schaid, DJ, Kokmen, E. (1994). Apolipoprotein E: risk factor for Alzheimer disease. Am J Hum Genet. 54. 643-649
  • Blanks, JC, Hinton, DR, Sadun, AA, Miller, CA. (1989). Retinal ganglion cell degeneration in Alzheimer's disease. Brain Res. 501. 364-372
  • Penfold, PL, Madigan, MC, Gillies, MC, Provis, JM. (2001). Immunological and aetiological aspects of macular degeneration. Prog Retin Eye Res. 20. 385-414
  • Mullins, RF, Russell, SR, Anderson, DH, Hageman, GS. (2000). Drusen associated with aging and age-related macular degeneration contain proteins common to extracellular deposits associated with atherosclerosis, elastosis, amyloidosis, and dense deposit disease. FASEB J.. 14. 835-846
  • Klaver, CC, Kliffen, M, van Duijn, V, Hofman, A, Cruts, M, Grobbee, DE. (1998). Genetic association of apolipoprotein E with age-related macular degeneration. Am J Hum Genet. 63. 200-206
  • Davignon, J, Cohn, JS, Mabile, L, Bernier, L. (1999). Apolipoprotein E and atherosclerosis: insight from animal and human studies. Clin Chim Acta. 286. 115-143