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American Journal of Epidemiology 2005 161(11):1013-1019; doi:10.1093/aje/kwi130
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved

ORIGINAL CONTRIBUTIONS

Exposure to Chlamydia pneumoniae Infection and Progression of Age-related Macular Degeneration

Luba Robman1, Olaimatu Mahdi2, Catherine McCarty1,3, Peter Dimitrov1, Gabriella Tikellis1, John McNeil4, Gerald Byrne2, Hugh Taylor1 and Robyn Guymer1

1 Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
2 Department of Molecular Sciences, University of Tennessee Health Science Center, Memphis, TN
3 Marshfield Clinic Research Foundation, Marshfield, WI
4 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia

Correspondence to Dr. L. Robman, Centre for Eye Research Australia, University of Melbourne, 32 Gisborne Street, East Melbourne 3002, Australia (e-mail: liubov{at}unimelb.edu.au).

Recent studies have found an association between exposure to Chlamydia pneumoniae infection and risk of age-related macular degeneration (AMD). To assess a potential risk of AMD progression posed by exposure to C. pneumoniae, the authors reexamined Australian residents in 2001–2002 who were aged 51–89 years with early AMD at baseline (1992–1995). Examination included macular photography and an enzyme-linked immunosorbent assay to determine antibody titers to the elementary bodies from C. pneumoniae AR39. AMD progression was assessed quantitatively, using both coarse and fine progression steps following an international classification for AMD grading, and also qualitatively, by side-by-side comparison of baseline and follow-up macular photographs. Serologic data were available for 246 of 254 (97%) subjects. AMD progression was associated with a higher antibody titer. After adjustment for age, smoking, family history of AMD, history of cardiovascular diseases, and source study, the subjects in the upper tertiles of antibody titers were 2.1 (95% confidence interval: 0.92, 4.69), 2.6 (95% confidence interval: 1.24, 5.41), and 3.0 (95% confidence interval: 1.46, 6.37) times more at risk of progression than those in the lowest tertile, using three definitions of progression, respectively. The fact that seroreactivity to C. pneumoniae was independently associated with the risk of AMD progression suggests that C. pneumoniae infection may be an additional risk factor for AMD progression.

Chlamydophila pneumoniae; disease progression; infection; macular degeneration

Abbreviations: AMD, age-related macular degeneration; VECAT, Vitamin E, Cataract, and Age-related Maculopathy Trial


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