Risk Factors for Age-Related Macular Degeneration (AMD)

By Lylas G. Mogk, M.D.
Edited by Maureen A. Duffy, M.S., CVRT

To understand what the risk factors are and what we can do to lower our risk for age-related macular degeneration (AMD), it's helpful to understand how macular degeneration develops:

  • First, advanced age and long-term environmental exposures together produce an increased number of free radicals: unstable molecules that damage the macula if they are not immediately neutralized by anti-oxidants.
  • Next, this initial damage causes inflammation; the inflammation then causes more damage, which results in more inflammation and the cycle continues, eventually scarring the macula and causing central vision loss.

To reduce the risk of AMD, we need to decrease our exposure to toxins, neutralize the free radicals that are produced by exposure to toxins, and decrease our inflammatory response. We can do that by addressing the first six of the ten risk factors listed below.

Top 10 Risk Factors for Developing Age-Related Macular Degeneration

The six risk factors we can control:

  1. Smoking: Current smokers have a two-to-three times higher risk for developing age-related macular degeneration than people have who never smoked.
  2. Artificial fats: Usually labeled "partially-hydrogenated vegetable oils," these artificial fats are pervasive in foods and particularly in low-fat bakery goods. Low-fat foods are good options if they've achieved their low-fat status through a process that physically removes the fat, as in skim milk or low-fat cottage cheese. Low-fat bakery goods are different, however. If you remove all or half the fat from a cake recipe, it won't turn into a cake; thus, when cakes and bakery goods are labeled low-fat or no-fat, it means they contain artificial fats, or laboratory-produced chemicals. These chemicals are not food and our bodies can't metabolize them.
  3. Sunlight: It is the blue wavelengths from the sun that damage the macula, not the ultraviolet (UV) rays. Read Artificial Lighting and the Blue Light Hazard from Prevent Blindness for more information.
  4. A diet high in processed, packaged foods and low in fresh vegetables: Vegetable oils are added in the packaging process. These oils are rich in omega-6 fatty acids, which promote inflammation.
  5. Uncontrolled hypertension and high cholesterol: Research by the National Eye Institute indicates that persons with hypertension are 1.5 times more likely to develop wet macular degeneration than persons without hypertension.
  6. Obesity: Being overweight doubles the risk of developing advanced macular degeneration.

The four risk factors we can't control:

  1. Advanced age: Although AMD may occur earlier, studies indicate that people over age 60 are at greater risk than those in younger age groups. For instance, a large study found that people in middle age have about a 2% risk of getting AMD, but this risk increased to nearly 30 percent in those over age 75.
  2. Race: Whites are much more likely to lose vision from age-related macular degeneration than are Blacks or African-Americans.
  3. A gene variant that regulates inflammation: While not all types of macular degeneration are hereditary, certain genes have been strongly associated with a person's risk of age-related macular degeneration, and genetic predisposition may account for half the cases of age-related macular degeneration in this country.
  4. Family history: Studies indicate that your chances of developing age-related macular degeneration are three to four times higher if you have a parent, child, or sibling with macular degeneration.

More about Risk Factors and Actions to Take

To decrease your risk of developing age-related macular degeneration, or to decrease the rate of progression if you already have age-related macular degeneration, here are some actions you can take:

  1. Don't smoke – and if you do smoke, try to stop.
  2. Don't eat packaged, processed foods, as much as possible.
  3. Don't eat artificial fats. Eat real bakery goods, made with real fat – just don't eat the whole box.
  4. Do wear sunglasses, preferably with an amber, brown, or orange tint that blocks blue light.
  5. Do eat lots of dark green leafy vegetables. These vegetables – such as kale, spinach, and collards – contain lutein, a substance that neutralizes the free radicals that will otherwise cause damage to the macula. If you are taking Coumadin and can't eat these vegetables because of the vitamin K in them, you can take a lutein supplement.
  6. Do eat lots of omega-3 fatty acids, which are found in fish, fish oil, flaxseeds, and some nuts. Omega-3 fatty acids reduce inflammation.
  7. Do control your blood pressure and cholesterol levels.
  8. Do exercise regularly and keep your weight down.

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