Association between atrial fibrillation and age‐related macular degeneration: A multinational cohort study

Purpose To assess whether atrial fibrillation (AF) is associated with an increased risk of age‐related macular degeneration (AMD). Methods This multinational retrospective cohort study included individuals aged 50 years or older, with or without AF at baseline, from healthcare organisations across 21 countries during 2015–2020 in the TriNetX database. Participants were classified into those with and without AF, and followed for up to 5 years to observe the occurrence of AMD, including both dry and wet forms, and other cerebrovascular outcomes. The AF and non‐AF groups were 1:1 propensity score‐matched to balance baseline characteristics and comorbidities. Outcomes were assessed using Cox regression models and Kaplan–Meier analysis. Results A total of 113 974 individuals were included in the final analysis. The mean follow‐up (standard deviation [SD]) is 4.09 (1.30) years in the AF group and 4.53 (0.95) years in the non‐AF group. During follow‐up, 1169 individuals developed AMD, 527 developed dry AMD, and 242 developed wet AMD. Compared to individuals without AF, those with AF have a significantly higher risk of developing AMD (hazard ratio [HR], 2.72; 95% confidence interval [CI], 2.42–3.11), dry AMD (HR, 2.55; 95% CI, 2.12–3.07), wet AMD (HR, 2.50; 95% CI, 1.90–3.28), and ischemic stroke (HR, 1.67; 95% CI, 1.60–1.73). Across most subpopulations, AF is consistently linked to higher risks of both dry and wet AMD. Conclusion Individuals with AF experience a higher risk of developing both dry and wet forms of AMD compared to individuals without AF.