Pre- and postoperative C-reactive protein levels in patients with cataract and age-related macular degeneration

PURPOSE. To assess whether patients with early or intermediate forms of age-related macular degeneration (AMD) benefit from cataract surgery in terms of visual acuity and contrast sensitivity, and to determine the levels of high sensitivity C-reactive protein (hsCRP) as a systemic marker of inflammation before and after cataract surgery in patients with AMD. METHODS. Three groups of patients (n=132) were studied at baseline and 8-12 weeks later: 1) a study group of patients with AMD who underwent cataract surgery (n=47), 2) a control group of patients without ocular comorbidities who underwent cataract surgery (n=36), and 3) a second control group with AMD and no surgery (n=49). Visual acuity (VA) was obtained by letter charts and expressed as decimal notations +/- SD. Contrast sensitivity was measured employing a Ginsburg Box, VSCR-CST-6500. The hsCRP was measured by means of particle enhanced immunonephelometry on a BN Systems. RESULTS. Postoperatively in both groups of the operated patients an improvement of VA (0.23+/-0.17 vs 0.64+/-0.25 and 0.23+/-0.18 vs 0.83+/-0.17, respectively, p<0.0001) and contrast sensitivity (at different spatial frequencies, from 1.5 to 18 cycles/degree, p<0.05) was determined. At baseline, the hsCRP level in Group 1 patients was higher than the level in controls (2.67+/-2.36 vs 1.67+/-1.36, p<0.01, or 1.12+/-0.99 mg/L, p<0.0001, respectively). After 8-12 weeks, the hsCRB level only in Group 1 significantly increased (2.67+/-2.36 vs 3.74+/-3.54 mg/L, p<0.05), whereas in the controls it did not change. CONCLUSIONS. Patients with AMD benefit from cataract surgery, both in terms of VA and contrast sensitivity. The level of hsCRP is significantly higher in patients with AMD and moderate cataract than in patients with one of these eye disorders. The hsCRP only increases after cataract surgery in patients with AMD.