Recent developments may unveil epidemiological implications for age-related macular degeneration
Denver, Colo.—Age-related macular degeneration (AMD) is a common eye disease that affects the macula, a part of the retina that controls sharp vision, which affects the central vision making it difficult for one to see fine details like reading, driving, or cooking. It is the leading cause of vision loss in older adults and has no cure. For now, there are treatment options that can slow or avert the advancement of AMD to the loss of light sensitive cells. Two studies presented at the 2022 Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO) in Denver, Colo. investigate how a drug that is used to fight a few of AMD’s risk factors, could possibly be a risk factor too and a different technique that could provide instrumental biomarkers, potentially improving the classification system for AMDs.
A certain medication for AMD risk factors linked to age of onset of AMD
Due to the negative outcomes from AMD, it is imperative that measures are taken to prevent getting this disease. Even though the causes are complicated, research has identified some risk factors such as smoking, being overweight/obese, high cholesterol levels, high blood pressure, and long-term sun exposure without eye protection. Some people can control these factors on their own, while others might need medication.
Durga Ganesh, BS, and researchers from SriniVas R. Sadda’s, MD, lab at the Doheny Eye Institute and Eran Halperin’s, PhD, lab at the University of California Los Angeles (UCLA) investigated if there was a relationship between the use of statin and the age of onset of AMD. They also evaluated other AMD risk factors such as diabetes mellitus (type 1 and type 2), ethnicity, fluoxetine use, hypertension, obesity, sex, and smoking history. The electronic health records (EHR) of 52,840 patients from the ophthalmology clinics at UCLA between 2014 through 2020 and 9,977 patients from the ophthalmology clinics at the University of California San Francisco between 2014 and 2019 were surveyed. Patients with an AMD diagnosis (6024/9.6%) were then included in the study and were also reviewed for all eight of the AMD risk factors and included in the regression model.
Ganesh and the team found that non-Hispanic Black ethnicity appeared to be associated with a later onset of AMD. Female sex, obesity, and the use of fluoxetine were associated with an earlier onset of AMD. Usage of statin and fluoxetine, obesity, and female sex were variables that looked to be only significantly associated with non-Hispanic white patients. Ganesh said, “based on our analysis of electronic health records of patients from UCLA and University of California, San Francisco (UCSF), statin use appears to be associated with a later age of onset of age-related macular degeneration."
- Abstract title: Effect of Statins on the Age of Onset of Age-Related Macular Degeneration
- Presentation start/end time: Wednesday, May 4, 10 – 10:17am MT
- Location: Four Seasons Blrm 1 (Denver Convention Center)
- Also available on the virtual meeting site at https://arvo2022.arvo.org/ beginning May 11
- Abstract number: 3524
Plasma metabolites and the future of complex eye diseases
AMD classifications are still mostly based on color fundus photographs (CFP). However, OCT offers important advantages to assess AMD pathology, and clinicians heavily rely on this technology to both diagnose and follow AMD patients. Indeed, OCT can identify numerous characteristics of AMD not detailed by CFPs, many of them with notable prognostic value. Yet, the pathophysiology of most of these features remains poorly understood. Research has shown that a technique called metabolomics (i.e., the study of small particles that are the downstream of genetic transcription processes and their interaction with environmental factors) can differentiate AMD patients from controls and contribute to the understanding of the mechanisms behind this complex disease. However, all these studies have been limited by using CFP classification systems.
Ines Lains, MD, PhD and her mentors, Joan W. Miller, MD and Deeba Husain, MD from the Massachusetts Eye and Ear/Harvard Medical School, Boston, US, in collaboration with researchers from Harvard T.H. Chan School of Public Health, the Brigham and Women’s Hospital, along with investigators from the Associação para Investigação Biomédica em Luz e Imagem (AIBILI) and Centro Hospitalar e Universitário de Coimbra, EPE, in Portugal, employed metabolomics to assess if plasma metabolomic profiles are connected with OCT features commonly seen in AMD.
They ran a cross-sectional, prospective study that included AMD patients and a control group from Coimbra, Portugal and Boston, United States. In addition to CFP, which were used for AMD classification, all patients were imaged with spectral-domain OCT. Lains and team them had two independent graders assessing the OCT images for specific AMD features according to a set protocol. Additionally, they collected fasting blood samples that were used for metabolomic profiling.
Their study included a total of 477 patients (381 of them had AMD, 96 were controls) and data on 718 named endogenous metabolites. The authors found several associations between plasma metabolites and OCT features, the most significant with hyperreflective foci, atrophy and ellipsoid disruption. Most of the identified metabolites were amino acids. Lains said that “These findings contribute to the current understanding of the many clinical phenotypes of AMD, which is important as it provide insights into possible future targets for treatment. Additionally, it supports that metabolomics may offer useful biomarkers for improved and more comprehensive classification systems for this complex disease.”
- Abstract title: Plasma Metabolites Associated with Optical Coherence Tomography (OCT) Features of Age-related Macular Degeneration (AMD)
- Presentation start/end time: Wednesday, May 4, 10:51 – 11:08am MT
- Location: Four Seasons Blrm 1 (Denver Convention Center)
- Also available on the virtual meeting site at https://arvo2022.arvo.org/ beginning May 11
- Abstract number: 3527
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The Association for Research in Vision and Ophthalmology (ARVO) is the largest eye and vision research organization in the world. Members include approximately 10,000 eye and vision researchers from over 75 countries. ARVO advances research worldwide into understanding the visual system and preventing, treating and curing its disorders. Learn more at ARVO.org.
All abstracts accepted for presentation at the 2022 ARVO Annual Meeting represent previously unpublished data and conclusions. This research may be proprietary or may have been submitted for journal publication. Embargo policy: Journalists must seek approval from the presenter(s) before reporting data from paper or poster presentations. Press releases or stories on information presented at the ARVO Annual Meeting may not be released or published until the following embargo dates:
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