Dr. Grossman’s Blog

Researchers predict age-related macular degeneration (AMD) will increase substantially by 2050, as the U.S. population ages, but the use of new and existing therapies can mitigate the effects of the condition.

A significant preventative therapy named in this study is the use of antioxidant vitamins to slow the progression of AMD from early to late stages.  Other treatments reviewed include laser and photodynamic therapies and anti-VEGF injections.

Scientists from the Research Triangle Institute International in North Carolina simulated cases of early AMD, choroidal neovascularization (CNV), geographic atrophy (GA), and AMD-attributable visual impairment and blindness with 5 universal treatment scenarios:

1. no treatment;
2. focal laser and photodynamic therapy (PDT) for CNV; 
3. vitamin prophylaxis at early-AMD incidence with focal laser/PDT for CNV; 
4. no vitamin prophylaxis followed by focal laser treatment for extra and juxtafoveal CNV and anti-vascular endothelial growth factor treatment; and 
5. vitamin prophylaxis at early-AMD incidence followed by CNV treatment, as in scenario 4.

From the results of this analysis, the researchers predicted that cases of early AMD will increase from 9.1 million in 2010 to 17.8 million in 2050 across all scenarios, but that existing medical therapies have the potential to reduce the visual impairment and blindness attributable to AMD by as much as 35 percent, translating to 565,000 fewer cases of visual impairment and blindness in 2050.

Learn about good food sources of antioxidants

Read about antioxidant vitamins important in the treatment of macular degeneration

SOURCE:  Forecasting age-related macular degeneration through the year 2050: the potential impact of new treatments, Rein, et al,  Arch Ophthalmol. 2009 Apr;127(4):533-40.

Long-term heavy smokers have a 2.5 to 3.5 times greater risk of losing vision from age-related macular degeneration, according to medical geneticist John R.W. Yates, Ph.D., of the University of Cambridge.

A study in the British Journal of Ophthalmology shows a strong link between smoking and age-related macular degeneration.  The study also shows the risks associated with exposure to second-hand smoke.

Researchers conducted a case-control study in four British counties to determine the relationship between smoking and either of the two forms of end-stage age-related macular degeneration — geographic atrophy and choroidal neovascularization.

Between 2001 and 2003, 435 participants with age-related macular degeneration were compared with 280 controls.  Of the 435 cases, 261 had choroidal neovascularization, 106 had geographical atrophy, and 68 had a mixed phenotype.   Smoking status was assessed by a questionnaire; smokers were defined as those who smoked at least one cigarette a day for a year.

Scientists found a statistically significant association between age-related macular degeneration and pack-years of smoking. Pack-years were defined as the number of packs smoked a day multiplied by the number of years smoked.

Specifically, for 40 or more pack-years:

• The risk was almost triple, compared with non-smokers, for age-related macular degeneration
• For choroidal neovascularization, the risk was more than double
• For geographic atrophy, the risk was more than triple.

Compared with non-smokers who weren’t exposed to second-hand smoke, the non-smokers who had such exposure had nearly twice the risk of having any form of age-related macular degeneration.

Learn more about macular degeneration including recommended self-help and nutrition to reduce your risk of blindness

Source:  “Smoking and age related macular degeneration: the number of pack years of cigarette smoking is a major determinant of risk for both geographic atrophy and choroidal neovascularization,” Khan, et al,  Br J Ophthalmol 2006;90:75-80.