AMD and Other Diseases: Any Connections?

Is there a connection between age-related macular degeneration (AMD) and conditions like diabetes, cataract, and glaucoma?

Speaking on a recent BrightFocus Chat University of Pennsylvania ophthalmologist Joshua Dunaief, MD, addressed the question of whether there is any connection between age-related macular degeneration and other diseases. For example, are there common medical problems that lead to AMD? Or does AMD increase the risk of conditions like cataracts or diabetes?

According to Dunaief, there are risk factors for AMD, especially high blood pressure. “In general, systemic inflammation is a risk factor for macular degeneration. It was shown some years ago in blood tests that people who have systemic inflammation measured by a test called C-reactive protein, or CRP, have an increased risk of macular degeneration. CRP levels are also a risk factor for heart disease.

“So, there is certainly a connection between systemic diseases, like heart disease, and macular degeneration in that inflammation can drive both of them – also neurodegenerative diseases like Alzheimer’s,” added Dunaief.

“Interestingly, patients who eat a plant-, fruit-, and vegetable-rich diet, with a reduction in simple sugars and a reduction in animal products, can lower their CRP levels. I think that it is likely to lower the risk of macular degeneration and other systemic diseases.”

Dr. Dunaief made the distinction with conditions such as cataracts and glaucoma. “A cataract is clouding of the lens, which can be treated with surgery if the lens gets cloudy enough to block light from getting into the eye: that’s not associated with macular degeneration, but it is an age-associated condition. Glaucoma is damage to the nerve in the back of the eye that is often caused by high eye pressure.”

If a person has high eye pressure, their eye doctor may treat it with eye drops, laser procedures or even surgery. “But again,” Dunaief said, “glaucoma is not known to be associated with macular degeneration; they are two separate diseases.”

Some diseases can have similar symptoms.

“Diabetes can also affect the retina like macular degeneration,” Dunaief said, stating, “Diabetes doesn’t increase the risk of macular degeneration, but it can cause some of the similar symptoms because the macula can be affected by something called diabetic macular edema, where blood vessels leak. And the diabetic retinopathy can also be treated with some of the same injections into the eye that block VEGF – Lucentis ®, Eylea ®, and Avastin® – because VEGF dries the leakiness of the blood vessels in diabetic retinopathy, too.”   Dr. Dunaief made these comments prior to the Food and Drug Administration’s approval of the new Beovu® injection.