Age-related Macular Degeneration: from risk profiles towards prediction models

Age-related macular degeneration (AMD) is a chronic disease and the leading cause of blindness in elderly in the Western World. Due to the aging population the number of affected persons is expected to increase, which will almost include 17 million affected persons in Europe in 2040. Newly associated genes and environmental factors have helped to elucidate a large part of the pathogenesis of AMD. These newly identified genes are involved in the complement cascade, lipid metabolism, extracellular matrix remodulation and angiogenesis. Thyroid hormone has been identified as a newly potential risk factor. An important modifiable risk factor is dietary intake. A diet of 200 grams of vegetables a day, 2 large pieces of fruit a day and 2 times fish per week has been associated with a 42% lower risk of AMD. This beneficial effect is most likely due to carotenoids, like lutein and zeaxanthin, and omega-3-fatty acids. A prediction model including demographic, genetic and environmental data could distinguish with an accuracy of 87% between those who will develop end stage AMD and those who will not. These findings can help future studies to further unravel the pathogenesis of AMD and ultimately develop preventative measures for this blinding disease.

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