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High genetic risk for AMD may predict benefit from antioxidants

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SAN FRANCISCO — Genetic risk and the use of antioxidants play a critical role in the development and progression of age-related macular degeneration, according to a study presented at the American Society of Retina Specialists meeting here.

“In persons without AMD, the genetic predisposition to develop AMD can be modified by antioxidant supplements. Antioxidants may be beneficial or detrimental based on individual genetic risk. Persons without AMD and with high genetic risk may benefit from antioxidant supplements. Persons without AMD and with low genetic risk should not take antioxidant supplements,” Carl Awh, MD, said.

Using data from the Age-Related Eye Disease Study, Awh and colleagues performed a sub-analysis of 554 patients for whom CFH and ARMS2 genotyping was available to determine the impact of genetic risk and antioxidant treatment on progression to intermediate AMD.

Results showed that 14.2% of patients progressed from no AMD to intermediate AMD over an average of 7.6 years.

Progression to intermediate AMD increased with increasing numbers of CFH and ARMS2 risk alleles; the risk was 6.48% for those with no risk alleles to 39.3% for those with three or four alleles, Awh said.

Patients with no genetic risk who used antioxidant supplements had a significantly increased risk of progression to intermediate AMD. Patients with a low genetic risk who used antioxidants had an elevated risk of progression to intermediate AMD.

Patients with a high genetic risk who used antioxidants had a significantly reduced risk of progression from no AMD to intermediate AMD.

“Individuals without AMD and with low genetic risk do not benefit from antioxidant treatment. In fact, antioxidant treatment may increase their risk of developing AMD,” Awh said. – by Matt Hasson and Patricia Nale, ELS

Reference:

Awh C. Treatment response to antioxidant supplementation based on CFH and ARMS2 genetic risk allele number in AREDS patients with no AMD at baseline. Presented at: American Society of Retina Specialists annual meeting; Aug. 9-14, 2016; San Francisco.

Disclosure: Awh reports he is a consultant for and a shareholder in ArcticDx.