(February 29, 2008 - Insidermedicine) The presence of age-related macular degeneration before the age of 75 is associated with a substantial increase in the risk of fatal MI or stroke, according to research published in the British Journal of Ophthalmology.

According to the American Academy of Ophthalmology, a diagnosis of age-related macular degeneration should include the following:

•    Taking a history, including assessment of the presence of symptoms, metamorphopsia, and decreased vision; use of medications and nutritional supplements; medical and ocular history; family history; and social history (especially of smoking)

•    Conducting a stereo biomicroscopic examination of the macula.

•    Conducting intravenous fundus fluorescein angiography when the patient complains of new metamorphopsia or has unexplained blurred vision, and/or when clinical examination reveals elevation of the retinal pigment epithelium or retina, subretinal blood, hard exudates, or subretinal fibrosis.

Researchers out of the Centre for Vision Research at the University of Sydney assessed the ophthalmic and general health of 3,600 individuals aged 49 and older between 1992 and 1994. Five years later, over 2,300 of these individuals received a follow-up assessment, and nearly 2,000 received another follow-up ten years later.

Those under the age of 75 that were identified as having early AMD at the start of the study were twice as likely to experience a fatal stroke or MI in the following decade, compared to those without this condition. The presence of late stage AMD was linked with a five times greater risk of having a fatal MI and a ten times greater risk of having a fatal stroke in the next decade.

For Insidermedicine in Depth, I'm Dr. Susan Sharma.