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β-blockers and Neovascular Age-related Macular Degeneration

2016; Elsevier BV; Volume: 124; Issue: 3 Linguagem: Inglês

10.1016/j.ophtha.2016.10.023

1549-4713

Ling Yeung, Ting Huang, Yun-Hsuan Lin, Kuang‐Hung Hsu, Jerry Chien‐Chieh Huang, Chi‐Chin Sun,

Retinal Imaging and Analysis

Neovascular age-related macular degeneration (nAMD) is the leading cause of irreversible visual impairment in elderly people. In recent years, many in vivo and in vitro studies have shown that β-blockers could be a possible new pharmacologic treatment for choroidal neovascularization. 1 Casini G. Dal Monte M. Fornaciari I. et al. The beta-adrenergic system as a possible new target for pharmacologic treatment of neovascular retinal diseases. Prog Retin Eye Res. 2014; 42C: 103-129 Crossref Scopus (52) Google Scholar However, clinical and epidemiologic studies have found inconsistent or even contradictory results. 2 Klein R. Myers C.E. Klein B.E. Vasodilators, blood pressure-lowering medications, and age-related macular degeneration: the Beaver Dam Eye Study. Ophthalmology. 2014; 121: 1604-1611 Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar , 3 Montero J.A. Ruiz-Moreno J.M. Sanchis-Merino E. et al. Systemic beta-blockers may reduce the need for repeated intravitreal injections in patients with wet age-related macular degeneration treated by bevacizumab. Retina. 2013; 33: 508-512 Crossref PubMed Scopus (30) Google Scholar , 4 Davis A. Cohen S.M. Pautler S.E. et al. Beta blocker use and age-related macular degeneration. Acta Ophthalmol. 2012; 90: e162-163 Crossref PubMed Scopus (8) Google Scholar , 5 Thomas A.S. Redd T. Hwang T. Effect of systemic beta-blockers, ace inhibitors, and angiotensin receptor blockers on development of choroidal neovascularization in patients with age-related macular degeneration. Retina. 2015; 35: 1964-1968 Crossref PubMed Scopus (15) Google Scholar In those studies that showed increased risk of nAMD in patients taking β-blockers, it is difficult to determine whether it is owing to the effect of β-blockers themselves or owing to the underlying diseases for which β-blockers were taken (e.g., hypertension). 2 Klein R. Myers C.E. Klein B.E. Vasodilators, blood pressure-lowering medications, and age-related macular degeneration: the Beaver Dam Eye Study. Ophthalmology. 2014; 121: 1604-1611 Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar Hypertension is a common systemic comorbid disease among nAMD patients with about 46% to 69% of nAMD patients having hypertension. β-blockers were frequently used antihypertensive medications. Therefore, this study aims to evaluate the effect of continuous β-blocker use in the incidence of new-onset nAMD in hypertensive patients. Re: Yeung et al.: β-blockers and neovascular age-related macular degeneration (Ophthalmology. 2017;124:409-411)OphthalmologyVol. 124Issue 9PreviewWe read with great interest the report by Yeung et al1 regarding the increased hazard among β-blocker (BB) users for neovascular age-related macular degeneration (nAMD).1 Certainly, the frequency with which BB are used makes the results of their study concerning. However, given the potential ramifications, we hope for further clarity on numerous issues regarding the study. Full-Text PDF