Preventive AMD Treatments Authors:

Introduction A better understanding of the pathophysiological processes occurring in “retinal aging” and age-related macular degeneration (AMD) has been achieved in recent years, leading to the emergence of new treatments and consequent long-term improvements in the patients quality of life. AMD is one of the leading causes of severe, irreversible vision impairment in developed countries, in individuals over 50 years of age. Approximately 1.75 million people over 40 in the United States suffer from neovascular AMD or geographic atrophy; 7.3 million patients display large drusen (≥125 microns) in one or both eyes(1). In the United States, AMD causes approximately 46% of severe visual loss cases (visual acuity of 20/200 or worse) in patients over 40(2). Although, an estimated 80% of AMD patients display the non-neovascular form of this disease, the neovascular form is responsible for almost 90% of cases of severe visual loss (visual acuity of 20/200 or worse) caused by AMD(3). Data from three population-based studies – the Beaver Dam Eye Study, the Rotterdam Study and the Blue Mountains Eye Study – have led to an estimated prevalence of advanced AMD of 0-2% in patients aged 55–64, increasing to 13% in patients over 85(4). Since there is no significant cure for AMD, prevention may be the first and logic approach to reduce vision loss, justifying an intensive search for some kinds of intervention able to prevent the onset of AMD or to delay its progression to more advanced and severe forms. Age is the main risk factor for AMD; all population-based studies confirm that the prevalence of AMD increases with age in white individuals(5,6,7). Belonging to the female gender may also constitute a risk factor in individuals aged over 75 years(4). Several studies also demonstrated that effective control of modifiable risk factors, such as smoking, hypertension and body-mass index, could reduce the risk of developing AMD by half(8). Since the early 90’s, when “large population studies” appeared, several hypotheses have been formulated around the idea that nutritional supplements, such as antioxidants, vitamins and/or minerals may be able to reduce the risk of AMD development.