C-reactive Protein Levels in Prediction of the Development or the Progression of Agerelated Macular Degeneration in Patients Examined at Tuzla Canton.

Background: Age-related macular degeneration (ARMD) is a chronic, incurable, progressive, multifactorial, neurodegenerative disease, which is one of the leading causes of visual impairment, among individuals above 60 years of age in developed countries. Over the past decades, the role of inflammation and CRP in the pathogenesis of ARMD has been investigated.

Objective: The study aimed to investigate the association between inflammation or CRP levels in prediction the development or the progression of ARMD.

Methods: This retrospective-prospective, case-control study, was conducted at the Clinic for Eye Diseases, University Clinical Center Tuzla, from 2020. to 2024. Two group of participants were included in this study. The first group (n=100 patients) consisted of patients diagnosed with different stages of ARMD, and second, control group (n=100 patients) consisted of patients without ARMD. The study included subjects of both sexes, divided into three age categories (≤55; 56-66; ≥67 years). Detailed ocular and systemic evaluations were performed, including fundus examination and OCT angiography. A 5mL sample of venous blood was colected to determine serum CRP levels, for the both group of patients, using latex immunoassay method. Statistical analysis, including Student's t-test, Chi square test and posthoc (Turkey) tests, was conducted using SPSS 26 for Windows, with p<0,05 considered significant.

Results: Out of 100 patients, 34 were having early, 18 intermediate and 48 were having advanced stages of ARMD. The mean serum CRP levels in the ARMD group (8.39±27.22mg/L) were significantly higher compared to the control group, (2.52±5.35mg/L), p=0,000. Also, serum CRP values by age category, between ARMD subjects and the control group, showed statistically significant differences in all age groups: ≤55 p=0.032; 56-66 p=0.019; ≥67 p=0.000. The mean serum CRP levels was 6.6±6.9 mg/L, 10±13.3 mg/L and 16±22.7 mg/L, in early, intermediate and advanced ARMD, respectively. Comparing these CRP values and different stages of ARMD, there were found statistically significant differences between the three stages. Furthermore, these results showed that mean CRP values increase with disease severity.

Conclusion: Based on the obtained results serum CRP levels are significant risk factor in predicting the development and the progression of ARMD. Also, these results emphasize the role of systemic inflammation in the development and progression of ARMD.