Previous studies show that patients with age-related macular degeneration (AMD) are likely to also have high serum lipid levels, but new research is showing that patients with elevated cholesterol going as far back as early middle age are likely to develop AMD later in life. Specifically, they found that high cholesterol may have a role in early AMD development, especially in patients who later develop large drusen. This may be due to early saturation of the Bruch’s-RPE basal membrane from serum lipids, which contributes to impaired transport and debris accumulation.

The research, presented at the ARVO 2019 meeting in Vancouver, took into consideration the records of 194 male subject whose total cholesterol (TC), triglyceride, blood pressure and body mass index (BMI) were recorded in the 1960s, when they were between the ages of 31 and 54 years old. Those same subjects’ eyes were evaluated between 2005 and 2012 using the AREDS classification system. They were monitored for drusen size; additionally, their lipids, BMI, smoking and statin use were all recorded in 2011.

The subjects who developed intermediate or late AMD by the most recent evaluation had significantly higher TC in their first evaluation. Those who measured high TC in the original evaluation also had the largest drusen size (≥125μm) compared with the rest of the subjects. Elevated BMI was associated with any level of AMD.

In 2011 TC, LDL and triglyceride levels were lower in patients with any AMD compared with those without. There was no difference in HDL levels.

Kananen F, Strandberg T, Loukovaara S, et al. Early middle-age cholesterol levels and the risk of age-related maculopathy. ARVO 2019. Abstract 1158.