Risk Profiles in AMD: What to tell Patients?
Westfälische Wilhelms-Universität Münster, Institut für Epidemiologie und Sozialmedizin, Münster
Purpose: Progressive age related macular degeneration (AMD) leads to loss of vision. Therapeutic options are limited and can in most instances only delay visual deterioration. Promising aspects of primary and secondary prevention are of great relevance to patients and doctors alike.
Method: Review of available evidence from epidemiologic and interventional studies identifying patient profiles that are related to increased risk or protection of AMD.
Results: Strongest risk factor in epidemiologic studies is past and current smoking. The evidence for occupational or leisure time exposure to light is inconsistent, probably as a consequence of methodological problems with exposure ascertainment. High relevance is presently assigned to antioxidants including macular pigment. Here again, the epidemiologic evidence is inconsistent and methodological differences of studies are substantial. The recently completed AREDS study has shown in a randomised, controlled design that application of antioxidants plus zinc reduces the progression rate from the early to the late stages of AMD. Another randomised study, investigating the impact of vitamin E supplementation, was unable to report any protective effects. Finally, the hypothesis that lipid lowering drugs such as statins have a protective effect on AMD was not confirmed when tested in a well-designed prospective study.
Conclusions: To date
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