LETTER TO THE EDITOR
Year : 2019 | Volume
: 67 | Issue : 1 | Page : 183--184
Comment on: Association of obesity and age-related macular degeneration in Indian population
Brijesh Takkar Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
Correspondence Address:
Dr. Brijesh Takkar Department of Ophthalmology, All India Institute of Medical Sciences, Saket Nagar, Bhopal - 462 020, Madhya Pradesh India
How to cite this article:
Takkar B. Comment on: Association of obesity and age-related macular degeneration in Indian population.Indian J Ophthalmol 2019;67:183-184
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Takkar B. Comment on: Association of obesity and age-related macular degeneration in Indian population. Indian J Ophthalmol [serial online] 2019 [cited 2024 Mar 29 ];67:183-184
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Full Text
Sir,
I read with interest the study “Association of obesity and age-related macular degeneration (ARMD) in Indian population” by Jaisankar et al.[1] The authors evaluate fundus images of patients with ARMD for possible association with obesity in a cross-sectional analysis. They conclude absence of a significant association between obesity and severity of ARMD following a logistic regression analysis.
In this study, the authors have chosen to use the worse eye for measuring the severity of ARMD while using a well-established grading system.[1] The choice of eye or the method of summation/averaging is crucial while assessing impact of any systemic parameter on an ophthalmic disease. Some of these methods include random selection of eyes, choice of worse eye, pairing of eyes, averaging the findings of the two eyes, and taking only right or left eye into account. Further, there is a need to apply correction factors for interocular correlations in such circumstances.[2],[3] While controlling for local factors, one expects a symmetric impact of a systemic factor like obesity on chronic diseases such as ARMD.
In lieu of this discussion, I encourage the authors to further authenticate their findings by analyzing inter-eye asymmetry in their study group. If obesity were to have any impact on ARMD, this asymmetry should be less in the obese population and also decrease with increasing grades of obesity. Next, it may also help by reanalyzing the dependent variable (severity of ARMD) in the “better eye.” Third, averaging of severity scores of ARMD may also be done. I suggest such further analysis as authors have stated themselves in this interesting study that the results of previous reports inclusive of a metanalysis have indicated an association between obesity and ARMD.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
1 | Jaisankar D, Swaminathan G, Roy R, Kulothungan V, Sharma T, Raman R, et al. Association of obesity and age-related macular degeneration in Indian population. Indian J Ophthalmol 2018;66:976-83. |
2 | Murdoch IE, Morris SS, Cousens SN. People and eyes: Statistical approaches in ophthalmology. Br J Ophthalmol 1998;82:971-3. |
3 | Fan Q, Teo YY, Saw SM. Application of advanced statistics in ophthalmology. Invest Ophthalmol Vis Sci 2011;52:6059-65. |
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