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PURPOSE To explore the association of AMD with long-term average blood pressure (BP) parameters, including pulse pressure (PP). METHODS The ALIENOR study is a population-based study on age-related eye diseases in 963 residents of Bordeaux, France, aged 73 years or older. AMD was graded from nonmydriatic color retinal photographs, in three exclusive stages: no AMD (1015 eyes), large soft distinct drusen and/or large soft indistinct drusen and/or reticular drusen and/or pigmentary abnormalities (early AMD, 276 eyes), and late AMD (66 eyes). BP parameters were measured at four occasions over a 7-year period. PP was defined as systolic BP minus diastolic BP. Associations of AMD with BP parameters were estimated using generalized estimating equation logistic regressions. Statistical analyses included 702 subjects (1357 eyes) with complete data. RESULTS After adjustment for age, sex, educational level, smoking, body mass index, plasma HDL and LDL cholesterol, CFH Y402H, ApoE2, ApoE4, and ARMS2 A69S polymorphisms, elevated PP was significantly associated with an increased risk of late AMD (odds ratio [OR] = 1.37 for a 10-mm Hg increase, 95% confidence interval [CI]: 1.03-1.82). Associations were similar for late atrophic and late neovascular AMD (OR = 1.39, 95% CI: 1.01-1.92, P = 0.04, and OR = 1.43, 95% CI: 0.90-2.23, P = 0.13, respectively). Association with early AMD was in the same direction but did not reach statistical significance (OR = 1.12, 95% CI: 0.98-1.28). Early and late AMD were not significantly associated with systolic or diastolic BP, hypertension, or use of antihypertensive medications. CONCLUSIONS This study suggests that high PP may be associated with increased risk for AMD.

PURPOSE. To assess the associations of complement factor H (CFH) Y402H polymorphism and smoking with specific features of early AMD (type, location, and area). METHODS. The ALIENOR study is a population-based study of age-related eye diseases in 963 residents of Bordeaux (France), aged 73 years or more. AMD features were graded from nonmydriatic color retinal photographs. CFH Y402H was genotyped by using DNA extracted from blood. Statistical analyses included 796 subjects with complete data. RESULTS. CFH CC genotype was strongly associated with late neovascular AMD (OR, 6.0; 95% confidence interval [CI], 1.5‐ 23.5) but not with late atrophic AMD (OR, 0.9; 95% CI, 0.2‐ 4.3). Among early characteristics, it was associated with central soft drusen (within 500 m of the fovea), whether of intermediate (63‐125 m; OR, 2.7; 95% CI, 1.5‐4.8), or large (125 m; OR, 5.9; 95% CI, 2.2‐15.7) size, but not with pericentral soft drusen (500‐3000 m from the fovea). It was also strongly associated with a large central area of soft drusen (OR, 5.7; 95% CI, 1.7‐19.2). Similarly, heavy smoking (20 pack-years) was strongly associated with central large drusen (OR, 3.9; 95% CI, 1.6‐9.6) and a large central area of drusen (OR, 3.5; 95% CI, 1.2‐10.0), but not with pericentral soft drusen. By contrast, both CFH CC and smoking tended to be more strongly associated with pericentral pigmentary abnormalities. CONCLUSIONS. Location of abnormalities, together with type and area, may prove useful for the identification of subjects at high risk for late AMD. (Invest Ophthalmol Vis Sci. 2011;52: 5955‐5962) DOI:10.1167/iovs.10-6235