ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2022-2-255-264ophthalmology-1841Research ArticleОБЗОРЫREVIEWSГиперметропия как фактор риска возрастной макулярной дегенерации. ОбзорHypermetropia as a Risk Factor for Age-Related Macular Degeneration. Reviewhttps://orcid.org/0000-0002-3175-9592ЛихванцеваВ. Г.LikhvantsevaV. G.

доктор медицинских наук, профессор кафедры офтальмологии,

Волоколамское шоссе, 91, Москва, 125310

МD, Professor of the Ophthalmology department,

Volokolamskoe highway, 91, Moscow, 125310

likhvantseva-4@yandex.ruКапковаС. Г.KapkovaS. G.

кандидат медицинских наук, доцент кафедры офтальмологии,

Волоколамское шоссе, 91, Москва, 125310

PhD, Assistant Professor of the Ophthalmology department,

Volokolamskoe highway, 91, Moscow, 125310

ГеворкянА. С.GevorgyanA. S.

офтальмолог,

Волоколамское шоссе, 91, Москва, 125310

ophthalmologist,

Volokolamskoe highway, 91, Moscow, 125310

НекрасоваЕ. Ю.NekrasovaE. Yu.

ординатор кафедры,

Волоколамское шоссе, 91, Москва, 125310

resident of the Department,

Volokolamskoe highway, 91, Moscow, 125310

ФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства»РоссияFederal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies FMBA of RussiaRussian Federation202230062022192255264Copyright © Лихванцева В.Г., Капкова С.Г., Геворкян А.С., Некрасова Е.Ю., 20222022Лихванцева В.Г., Капкова С.Г., Геворкян А.С., Некрасова Е.Ю.Likhvantseva V.G., Kapkova S.G., Gevorgyan A.S., Nekrasova E.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ophthalmojournal.com/opht/article/view/1841

Авторы представили полный комплексный анализ совокупных данных 11 поперечных (статичных) и 11 когортных продольных исследований с продолжительностью наблюдения от 5 до 14 лет, 16 исследований по типу «случай-контроль», а также 3 системных метаанализов и 1 «зонтичного» исследования с оценкой научной гипотезы, согласно которой гиперметропия является фактором риска развития возрастной макулярной дегенерации (ВМД). В этих исследованиях ВМД верифицировали по диагностическим критериям трех разных классификационных систем: критериям Национального института глаза, Международной системы по изучению возрастной макулопатии и Висконсинской классификации WARMGS. В общей сложности были охвачены 82 308 пациентов с ВМД. Анализировали 3 исходных показателя в популяции: исходную гиперметропию, сферический коэффициент (SE) и осевую длину глаза (AL), с одной стороны, и распространенность ВМД — с другой. Рассчитывали традиционные статистические показатели: отношение риска (OР) ВМД среди гиперметропов по сравнению с эметропами и 95 % доверительный интервал (ДИ). Объединенные данные метаанализов показали значимые ассоциации между дальнозоркостью, SE, AL и распространенностью ранней ВМД. Объединенные ОР и 95 % ДИ составили: 1,13 (1,06–1,20), 1,10 (1,07–1,14), и 0,79 (0,73–0,85) соответственно. Увеличение SE на одну диоптрию коррелировало с ранней ВМД (ОР 1,06; 95 % ДИ 1,02–1,10). При поздней ВМД не подтвердилась связь с аномалией рефракции. Данные зонтичного метаанализа понизили статистическую значимость этой связи для ранней ВМД (ОР = 1,08, 95 % ДИ 1,01–1,18); для поздней ВМД (ОР = 0,84, 95 % ДИ 0,77–0,91). В целом эксперты пришли к выводу, что вероятность развития ВМД зависит от рефракционного статуса пациента. 

The authors presented a complete comprehensive analysis of the combined data of 11 cross-sectional (static) and 11 longitudinal cohort studies with follow-up durations of 5 to 14 years, 16 case-control studies, as well as 3 systemic meta-analyses and 1 “umbrella” study evaluating the scientific hypothesis that hypermetropia is a risk factor for the development of age-related macular degeneration (AMD). In these studies, AMD was verified against the diagnostic criteria of three different classification systems: those of the National Eye Institute (USA), the International System for the Study of Age-Related Maculopathy, and the Wisconsin Classification WARMGS. A total of 82308 patients with AMD were enrolled. 3 baseline indicators in the population were analyzed: the initial hypermetropia, the spherical coefficient (SE) and the axial length of the eye (AL), on the one hand, and the prevalence of AMD, on the other hand. Traditional statistical indicators were calculated: the risk ratio (RR) of AMD among hypermetropes compared to emetropes and a 95 % confidence interval (CI). Pooled data from meta-analyses showed significant associations between farsightedness, SE, AL, and the prevalence of early AMD. The combined RR and 95 % CI were: 1.13 (1.06–1.20), 1.10 (1.07–1.14), and 0.79 (0.73–0.85), respectively. An increase in SE by diopter was correlated with early AMD (RR 1.06; 95 % CI 1.02–1.10). The late AMD did not confirm its association with the refractive error. The umbrella meta-analysis lowered the statistical significance of this association for early AMD (RR 1.08, 95 % CI 1.01–1.18); with late AMD (RR 0.84, 95 % CI 0.77–0.91). In general, experts came to the conclusion that the likelihood of developing AMD depends on the refractive status of the patient. 

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The authors declare that there are no conflicts of interest present.