Published: 2019-03-27

Association between C-reactive protein and age-related macular degeneration

Mitali Borooah, Jayant Ekka


Background: Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment among the elderly, worldwide affecting 30-50 million individuals. Inflammation is now increasingly thought to be a key risk factor for AMD. The association of CRP with AMD has been reported in only a few studies, with somewhat inconsistent results. The present study was undertaken to determine the association between AMD and serum CRP levels.

Methods: A total of 53 patients diagnosed of any form of AMD fulfilling inclusion and exclusion criteria were included. A 5 mL sample of venous blood (non-fasting) was collected to determine serum high-sensitivity CRP levels (hsCRP). Different stages of AMD and serum hs CRP level were compared using one-way ANOVA test and calculated p value <0.05 was considered as statistically significant. Comparison between the two groups, one with risk factor and one without risk factor was performed using student-t test and calculated p value <0.05 was considered statistically significant.

Results: Out of 53 patients 21 were having early AMD, 21 were having intermediate AMD and 11 were having advanced AMD. The mean serum hs CRP level was 0.14±0.05 mg/dL, 0.20±0.09 mg/dL and 0.28±0.08 mg/dL in early, intermediate and advanced AMD respectively. When statistically analysed the difference of mean serum hs CRP level among the three groups was found to be statistically significant.

Conclusions: Type of AMD influence the baseline hsCRP level. Smoking and diabetes are associated with higher baseline serum hsCRP in all stages of AMD.


Age-related macular degeneration (AMD), C-reactive protein, Choroidal neovascular membrane, Drusen, Geographical atrophy, hsCRP

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Resnikoff S, Pascolini D, Etya'Ale D, Kocur I, Pararajasegaram R, Pokharel GP, et al. Global data on visual impairment in the year 2002. Bulletin World Health Organization. 2004;82:844-51.

Bird AC, Bressler NM, Bressler SB, Chisholm IH, Coscas G, Davis MD, et al. An international classification and grading system for age-related maculopathy and age-related macular degeneration. Survey Ophthalmol. 1995;39(5):367-4.

Friedman DS, O’Colmain BJ, Munoz B, Tomany SC, McCarty C, De Jong PT, et al. Prevalence of age-related macular degeneration in the United States. Arch ophthalmol. 2004;122(4):564-72.

Klein R, Peto T, Bird A, Vannewkirk MR. The epidemiology of age-related macular degeneration. Am J Ophthalmol. 2004;137(3):486-95.

Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, et al. Ranibizumab for neovascular age related macular degeneration. New Eng J Med. 2006;355(14):1419-31.

World Health Organization. Age related macular degeneration: priority eye diseases. Accessed at:

Age-related eye disease study research group. The age-related eye disease study system for classifying age-related macular degeneration from stereoscopic color fundus photographs: the age-related eye disease study report number 6. Am J Ophthalmol. 2001;132(5):668-81.

Seddon JM, Gensler G, Milton RC, Klein ML, Rifai N. Association between C-reactive protein and age-related macular degeneration. JAMA. 2004;291(6):704-10.

McGwin G, Hall TA, Xie A, Owsley C. The relation between C reactive protein and age-related macular degeneration in the Cardiovascular Health Study. British J Ophthalmol. 2005;89(9):1166-70.

Schaumberg DA, Christen WG, Buring JE, Glynn RJ, Rifai N, Ridker PM. High-sensitivity C-reactive protein, other markers of inflammation, and the incidence of macular degeneration in women. Archives Ophthalmol. 2007;125(3):300-5.

Steel DM, Whitehead AS. The major acute phase reactants: C-reactive protein, serum amyloid P component and serum amyloid A protein. Immunol Today. 1994;15(2):81-8.

Boekhoorn SS, Vingerling JR, Witteman JC, Hofman A, de Jong PT. C-reactive protein level and risk of aging macula disorder: The Rotterdam Study. Archives Ophthalmol. 2007;125(10):1396-401.

Čolak E, Kosanović-Jaković N, Žorić L, Radosavljević A, Stanković S, Majkić-Singh N. The association of lipoprotein parameters and C-reactive protein in patients with age-related macular degeneration. Ophthalmic Res. 2011;46(3):125-32.

Boey PY, Tay WT, Lamoureux E, Tai ES, Mitchell P, Wang JJ, et al. C-reactive protein and age-related macular degeneration and cataract: the Singapore Malay Eye Study. Inv Ophthalmol Visual Sci. 2010;51(4):1880-5.

Thornton J, Edwards R, Mitchell P, Harrison RA, Buchan I, Kelly SP. Smoking and age-related macular degeneration: a review of association. Eye. 2005;19(9):935.

McCarty CA, Mukesh BN, Fu CL, Mitchell P, Wang JJ, Taylor HR. Risk factors for age-related maculopathy: the visual impairment project. Archives Ophthalmol. 2001;119(10):1455-62.

Klein R, Klein BE, Tomany SC, Meuer SM, Huang GH. Ten-year incidence and progression of age-related maculopathy: The beaver dam eye study. Ophthalmol. 2002;109(10):1767-9.

Vingerling JR, Hofman A, Grobbee DE, De Jong PT. Age-related macular degeneration and smoking: the Rotterdam Study. Archives Ophthalmol. 1996;114(10):1193-6.

Khan JC, Thurlby DA, Shahid H, Clayton DG, Yates JR, Bradley M, et al. Smoking and age-related macular degeneration: the number of pack years of cigarette smoking is a major determinant of risk for both geographic atrophy and choroidal neovascularisation. British J Ophthalmol. 2006;90(1):75-80.

Christen WG, Glynn RJ, Manson JE, Ajani UA, Buring JE. A prospective study of cigarette smoking and risk of age-related macular degeneration in men. JAMA. 1996;276(14):1147-51.

Wilson GA, Field AP, Wilson N. Smoke gets in your eyes: smoking and visual impairment in New Zealand. New Zealand Med J. 2001;114(1142):471.

Snow KK, Seddon JM. Do age-related macular degeneration and cardiovascular disease share common antecedents?. Ophthalmic Epidemiol. 1999;6(2):125-43.

Ridker PM, Stampfer MJ, Rifai N. Novel risk factors for systemic atherosclerosis: a comparison of C-reactive protein, fibrinogen, homocysteine, lipoprotein (a), and standard cholesterol screening as predictors of peripheral arterial disease. JAMA. 2001;285(19):2481-5.

Ridker PM. Clinical application of C-reactive protein for cardiovascular disease detection and prevention. Circulation. 2003;107:363-9.