• Written By: Alma I Murphy, MD
    Comprehensive Ophthalmology

    This prospective, population-based study found that AMD is very common among those aged ≥ 85 years and confirmed its direct association with HDL cholesterol and body mass index (BMI).

    They investigated the incidence and progression of AMD and associated risk factors in 2,868 participants from the Age Gene/Environment Susceptibility-Reykjavik Study with retinal data at baseline and five-year follow-up. The mean age at baseline was 74.4 years in this predominately Caucasian Icelandic population. 

    The estimated incidence of AMD was approximately 3% per year. More than 95% of the incident cases were classified as early lesions. The rate of progression of AMD from early to late was approximately 4.5% per year distributed in roughly equal proportions between general atrophy and exudative disease. More than 55% of adults aged ≥ 85 years exhibited signs of AMD in ≥ 1 eye.

    Risk factors for incident AMD included older age, higher BMI, smoking and high levels of HDL cholesterol, whereas the main risk factor for AMD progression was older age, with females more likely than males to progress to exudative disease and those with higher HDL cholesterol levels more likely than those with lower levels to progress to geographic atrophy.

    The authors write that these results are similar to those seen in other studies of Caucasian populations.

    They conclude that the relationship of higher plasma HDL cholesterol with risk of early AMD and with progression to geographic atrophy requires further study. Determining whether different processes or biomarkers, tracked over time, influence the development or progression of the two advanced forms of AMD may be important for prognosis, prevention and future treatment.

    Elderly AMD patients may not be aware of the risk of AMD progression. What methods do you use to inform patients of this risk and to encourage early detection of exudative disease?