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Ten-year study data reveal progression predictors for neovascular AMD
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ATLANTA — The Age-Related Eye Disease Study released 10-year follow-up data showing that smoking, age and AREDS supplementary treatment are predictors for 10-year progression rates, a presenter said here.
“We have different effects on the rates of progression in neovascular [age-related macular degeneration] and central geographic atrophy, particularly by risk factors, including smoking and the AREDS treatment,” Emily Y. Chew, MD, said at the Retina Subspecialty Day preceding the American Academy of Ophthalmology meeting. “We hope these data will be important for you to help discuss advanced AMD risks with your patients and reassure those with little or low risk for progression to advanced AMD.”
Additional data
The study of 4,757 patients has 10.6 mean years of follow-up, looking at the 10-year rates of AMD and risk factors for its progression.
Dr. Chew said the baseline AMD score, which reflects the severity of baseline AMD, shows increasing risk with increasing severity of AMD.
For patients with no large drusen in either eye at baseline, or score 0 (mildest grade), the rate of advanced AMD at 10 years is 1.1%; advanced AMD in one eye or both eyes with large drusen with pigmentary changes at baseline, or score 4 (the most severe end of the scale), had a rate of 72% at 10 years.
“It’s a great relief for patients who have no large drusen that, at 10 years, their rate of AMD is extremely low,” Dr. Chew said.
The other factors for progression of neovascular AMD were age, smoking status and treatment with AREDS supplements, consisting of antioxidant vitamins and minerals (zinc and copper).
“With increasing age, at all baseline severity of AMD, there is an increasing risk of advanced AMD,” she said. “No matter what stage, smoking ... is not good. Even those who smoked before and stopped are not quite as good as those who’ve never smoked, so there’s a suggestion that this is a modifiable risk factor.”
The other modifiable risk factor for neovascular AMD is the use of AREDS supplements.
“With neovascular AMD, there is a decrease in the progression to this form of advanced AMD in those who have been treated with AREDS supplements,” Dr. Chew said. “However, if you look at geographic atrophy, there appears to be no difference.”
Available to all
The National Eye Institute (NEI) said the data will be available to clinicians through the online database of genotypes and phenotypes, or dbGaP.
“Now that the entire AREDS database is available to the global research community, we hope that researchers will be inspired to delve more deeply into analyzing the genetic and environmental factors involved in the onset and progression of age-related macular degeneration and age-related cataract,” Frederick L. Ferris III, MD, clinical director of the NEI, said in a press release.
The National Library of Medicine’s National Center for Biotechnology Information operates dbGaP, which has two access levels. The public section includes study descriptions and documents such as protocols, and the controlled-access section, available to approved researchers, includes genotype and phenotype data such as that of individual AREDS participants. The information is coded to protect the patients.
The latest data show complete information obtained from the AREDS participants, including data photographs of the patients’ eyes, nutritional intake, quality of life and rates of illness and death.
“Genetic testing has become crucial in the advancement of science, both for understanding the progression of diseases and for determining appropriate research directions for treatments,” Paul A. Sieving, MD, PhD, director of the NEI, said in the release. “With the AREDS data available through dbGaP, vision researchers can continue to identify genetic factors that may play a role in eye conditions such as age-related macular degeneration and cataract.”
For more information:
- Emily Y. Chew, MD, can be reached at the National Eye Institute, 31 Center Drive, Bethesda, MD 20892-2510; 301-496-6583; fax: 301-496-2297; e-mail: echew@nei.nih.gov.