Age-related macular degeneration and long-term risk of stroke subtypes

M. Kamran Ikram, Paul Mitchell, Ronald Klein, A. Rickey Sharrett, David J. Couper, Tien Y. Wong

Research output: Contribution to journalReview articlepeer-review

35 Scopus citations


Background and Purpose-: We examined the relationship of age-related macular degeneration (AMD) with incident stroke, including stroke subtypes of cerebral infarction and intracerebral hemorrhage. Methods-: We included 12 216 participants with retinal photographs taken at the third examination visit (1993-1995) from the Atherosclerosis Risk in Communities (ARIC) Study, a population-based cohort study in middle-aged persons. Images were evaluated for AMD signs according to a standardized protocol. Incident events of stroke and its subtypes were identified and validated through case record review over time. Results-: AMD was diagnosed in 591 participants, of whom 576 had early and 15 late AMD. After a mean follow-up of 13.0 years (SD, 3.3), 619 persons developed an incident stroke, including 548 cerebral infarction and 57 intracerebral hemorrhages. Participants with any AMD were at an increased risk of stroke (multivariable adjusted hazard ratio, 1.51; 95% CI, 1.11-2.06) with a stronger association for intracerebral hemorrhage (hazard ratio, 2.64; 95% CI, 1.18-5.87) than cerebral infarction (hazard ratio, 1.42; 95% CI, 1.01-1.99). Conclusions-: Persons with AMD are at an increased risk of both cerebral infarction and intracerebral hemorrhage. These data provide further insight into common pathophysiological processes between AMD and stroke subtypes.

Original languageEnglish (US)
Pages (from-to)1681-1683
Number of pages3
Issue number6
StatePublished - Jun 2012
Externally publishedYes


  • age-related macular degeneration
  • cerebral infarction
  • intracerebral hemorrhage
  • retinal imaging

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing


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