The effect of long-term systemic immunosuppressive drug use on druse formation: a new perspective to age-related macular degeneration

BACKGROUND/AIM: To evaluate the effect of the long-term use of systemic immunosuppressive drugs on druse formation in patients aged over 50 years. MATERIALS AND METHODS: The current retrospective cohort study includes 420 eyes of 420 patients. 210 eyes of 210 patients who used immunosuppressive drugs (Group 1) at least for the last 5 years and 210 eyes of 210 control patients (Group 2) who did not use any drugs were compared. All patients were older than 50 years and selected among patients who were followed by rheumatology and ophthalmology clinic at a tertiary university hospital. All patients had complete ophthalmic examination, fundus photography and optical coherence tomography (OCT). The primary outcome of this study is the difference in macular and paramacular druse formation rates between two groups. RESULTS: Small, intermediate, large, soft, and paramacular druse formation rates were significantly lower in Group 1 than those in Group 2 (P = 0.028, P = 0.001, P = 0.001, P = 0.001, and P = 0.001, respectively). CONCLUSION: Patients who used long-term systemic immunosuppressive drugs had significantly lower hard and soft druse formation rate than age and sex matched control subjects.