Update on modifiable risk factors for age-related macular degeneration

28 November 2010
Volume 11, Issue 4
AMD

Evaluating the risk of AMD amongst construction workers in Ireland.

Background

Age-related macular degeneration (AMD) is the commonest cause of age-related blindness in developed countries, and it is estimated that there are approximately 80 000 people affected by this condition in Ireland, with over 12 million sufferers across Europe. Although the pathogenesis of AMD remains unclear, there is a growing consensus that free radical damage induced by cumulative short-wavelength light (blue) and oxidative stress plays a role in its development (Beatty et al. 2000). 

The three undisputed risk factors for AMD are: (1) increasing age; (2) positive family history of disease; and (3) cigarette smoking. Tobacco use is, therefore, the only proven environmental/lifestyle risk factor for this disease (Chakravarthy et al. 2007; Klein et al. 1998; Tan et al. 2007). However, there is a growing body of evidence that other variables are associated with increased risk for AMD and these include white race, dietary deficiency of antioxidants relevant to retinal health, undesirable body mass index (BMI), hypertension (high blood pressure), hypercholesterolaemia and chronic and cumulative exposure to ambient short-wavelength visible light (SanGiovanni et al. 2007; Tomany et al. 2004). 

It would appear, therefore, that construction workers in Ireland are at increased risk of developing blindness (ie AMD) in later life, as they are exposed to many of the above-mentioned variables in a way that is not true for their office-based counterparts. Furthermore, and given that we are living in an era of unprecedented and ever-increasing life expectancy, risk for AMD needs to be assessed at a time in the individual’s life when preventive measures are likely to reduce such risk. For example, smoking cessation in a 35-year-old male will reduce his risk of developing AMD in later life, but this would not be true if he was to discontinue tobacco use at, say, age 65 years (Cai et al. 2000). 

We have conducted a study to evaluate risk for AMD amongst construction workers in Ireland, and to furnish those workers with advice to reduce their risk of developing this condition in a way that is evidence-based and tailored to the individuals’ risk profiles.

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