Age-Related Macular Degeneration in Patients with Androgenetic Alopecia: Could the Monocyte/HDL Ratio Be the Link?

Introduction: Both Androgenetic alopecia (AGA) and age-related macular degeneration (AMD) shared the microinflammatory milieu and increased oxidative stress as important criteria in pathogenesis.   Objectives: To assess the monocyte/High density lipoprotein (HDL) ratio (MHR) in patients with AGA and its correlation to AMD in these patients, if any. Methods: 40 patients with AGA aged 40 years or more of both sexes and 40 control subjects participated in this case-control study. General, dermatological, and ophthalmologic examination, MHR evaluation and optical coherence tomography (OCT) were performed. Results: The mean MHR was significantly higher in AGA patients (6.98 ± 2.21) than controls (3.82 ± 0.68) (p<0.001). AMD was significantly higher in patients than control (p <0.001). 80% of patients were diagnosed with AMD vs 20% of control subjects. Presence of AMD in AGA was significantly related to the degree of severity of AGA in male patients (P= 0.02). MHR was significantly higher in AGA patients found to have AMD (9.37 ± 1.1 and 7.01 ± 1.42 in wet and dry type respectively) than those without AMD (P<0.001). The best cutoff value of MHR in prediction of wet type among patients of AGA is ≥8.2337 with overall accuracy 80%. While the best cutoff value of MHR in prediction of dry type among AGA patients is ≥4.1408 to <8.2337 with overall accuracy 86.7%. Conclusion: AMD may develop more frequently in those with AGA, and this may correspond with the disease's severity. MHR seems to be a missing link between both conditions