AMD = age-related macular degeneration.
Letter to the Editor
Beta blocker use and age-related macular degeneration
Article first published online: 8 JUN 2011
Copyright © 2011 Acta Ophthalmologica Scandinavica Foundation
Volume 90, Issue 2, pages e162–e163, March 2012
How to Cite
Davis, A., Cohen, S. M., Pautler, S. E., Billiris-Findlay, K. and Eichenbaum, D. A. (2012), Beta blocker use and age-related macular degeneration. Acta Ophthalmologica, 90: e162–e163. doi: 10.1111/j.1755-3768.2011.02117.x
- Issue published online: 28 FEB 2012
- Article first published online: 8 JUN 2011
Through serendipity, Léauté-Labrèze et al. discovered that propanolol induces regression of infantile hemangiomas (Léauté-Labrèze et al. 2008; Siegfried et al. 2008). A non-selective beta blocker, propranolol, may affect involution of infantile hemangioma by decreasing the expression of vascular endothelial growth factor (VEGF).
Since propranolol may cause decreased expression of VEGF, oral or topical beta blockers may have a beneficial effect on patients with age-related macular degeneration (AMD). We retrospectively compared the use of oral and topical beta blocker medication in patients with wet and dry AMD to identify a possible protective effect of beta blockers against choroidal neovascularization.
The medical records of all new patients who were referred to our group retina practice between January 1, 2007 and December 31, 2008 were screened for inclusion in this study. A diagnosis of AMD was confirmed by reviewing the history, examination, and diagnostic testing. Each eye was categorized as dry or wet AMD based on the age-related eye disease study classification (AREDS Study Group 2001).
Patients with wet AMD in either eye were categorized as a wet AMD for the purpose of this study. One thousand and five charts were reviewed. Nine hundred nineteen patients were included in the study.
The study complied with the Declaration of Helsinki. The research protocol was approved by the institutional review board of the University of South Florida.
Of the 919 patients included in the study, 363 had wet AMD in at least one eye. Sixteen (6%) of 363 patients with wet AMD were current smokers and 26 (5%) of 556 patients with dry AMD were current smokers. The average age of patients included in the study was 84 (Table 1).
|All||Wet AMD||Dry AMD||Beta blocker||No beta blocker|
|Number (N)||919||363 (39%)||556 (61%)||288 (31%)||631 (69%)|
|Smokers (N)||49 (5%)||23 (6%)||26 (5%)||15 (5%)||34 (5%)|
|Oral beta blocker (N)||290 (32%)||115 (32%)||175 (31%)|
|Oral non Selective beta blocker (N)||58 (6%)||22 (6%)||36 (6%)|
|Topical beta blocker||57 (6%)||21 (6%)||36 (6%)|
There was no significant difference in use of oral selective beta blocker, oral non-selective beta blocker or topical beta blocker medications between patients with wet AMD and patients with dry AMD (Table 1).
The variable course of patients treated for wet AMD suggests that there are yet to be determined factors that may affect the clinical course patients with AMD. We chose to look for a link between beta blocker usage and wet AMD because beta blockers are useful in treating infantile hemangioma and they have a long history of safe use for cardiovascular disease.
Our study showed no difference in beta blocker usage between patients with dry AMD and wet AMD (Table 1). The negative findings of this study – that the percentage of patients using topical or oral beta blockers was the same in the wet AMD group and the dry AMD group – suggest that beta blockers do not protect patients from developing wet AMD.
- AREDS Study Group (2001): The AREDS system for classifying age-related macular degeneration from stereoscopic color fundus photographs. AREDS Report No. 6. Am J Ophthalmol 132: 668–681.
- 2008): Propranolol for severe hemangiomas of infancy. N Engl J Med 358: 2649–2651. , , , , & (
- 2008): More on propranolol for hemangiomas of infancy. N Engl J Med 359: 2846–2847. , & (