Alcohol Consumption and Risk of Age-Related Macular Degeneration and Geographic Atrophy Progression: Age-Related Eye Diseases Study 2 Report 34.

purposeTo examine potential relationships between alcohol consumption and age-related macular degeneration (AMD) progression, including progression to late AMD and geographic atrophy (GA) enlargement rate.

designPost hoc analysis of cohorts within the Age-Related Eye Diseases Study 2.

participantsA total of 6670 eyes (of 3673 participants) with no late AMD at baseline; 1143 eyes (of 841 participants) with GA at ≥2 consecutive visits.

methodsColor fundus photographs were collected at annual study visits and graded centrally for late AMD, GA area, and GA proximity. Alcohol consumption was calculated by food frequency questionnaire. Regression analyses of disease progression were performed according to alcohol consumption.

main outcome measuresProgression to late AMD and its subtypes; GA area-based progression; GA proximity-based progression.

resultsOver a mean follow-up of 4.5 years, 40.2% of eyes progressed to late AMD. In men, with alcohol tertile 1 (no regular consumption) as reference, hazard ratios for progression to late AMD were 0.69 (95% confidence interval [CI], 0.55-0.87; P = 0.0015) for tertile 2 and 0.85 (0.71-1.02; P = 0.079) for tertile 3. In women, hazard ratios were 1.12 (0.95-1.31, P = 0.17) and 0.85 (0.72-1.00, P = 0.046), respectively. Over a mean follow-up of 3.1 years, GA area-based progression was significantly faster in women than men, at 0.295 (95% CI, 0.278-0.311) and 0.260 mm/year (95% CI, 0.241-0.279), respectively (P = 0.007). In men, area-based progression differed significantly by alcohol tertile (P = 0.0001), at 0.275 (95% CI, 0.248-0.303), 0.183 (95% CI, 0.143-0.223), and 0.280 mm/year (0.254-0.306) in tertiles 1 to 3, respectively. In women, the area-based rate did not differ significantly by alcohol tertile (P = 0.11). In men only, Centers for Disease Control and Prevention-defined heavy drinking was associated with faster progression (P = 0.024), at 0.306 (95% CI, 0.262-0.349) versus 0.252 mm/year (95% CI, 0.233-0.270). In 808 eyes with noncentral GA, GA proximity-based progression did not differ significantly by alcohol tertile (P = 0.55).

conclusionsModerate alcohol consumption is associated with decreased risk of progression to late AMD in men. Geographic atrophy progression is faster in women, but its relationship with alcohol consumption is much stronger in men. In men, moderate consumption is associated with slower GA progression and higher consumption with faster progression. Although some of these associations may also relate to confounding, they might suggest that individuals with GA should avoid high alcohol consumption. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.