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In this MD Newsline exclusive interview with vitreoretinal specialist Dr. Rishi Singh, we discuss risk factors for wet AMD.

MD Newsline:

Is there a genetic predisposition for wet AMD?

Dr. Rishi Singh:

“There is definitely a genetic predisposition. We know that there’s mutations in various complement factors and other factors within the genome that cause this condition. And there’s certainly familial-related situations where multiple members of the family will develop the same condition.

So there’s definitely a heritable component or genetic component that’s present. And that’s where I think the majority of our time is spent sometimes in the office asking patients about family members that might have this disease or other loved ones that might have this disease because we want to make sure they get seen as well [and] make sure they’re evaluated and managed appropriately.”

 

MD Newsline:

Why do you think, on average, more women than men are affected by wet AMD?

Dr. Rishi Singh:

“I think this gets back again to the genome, between females and males, there’s definitely a difference there, and this genetic component we’re talking about obviously has some component that goes along with the female gender that puts them at a greater risk.

The other thing I can tell you is that females tend to live longer than males, as we know from population-based studies. And so, as we know, one of the big risk factors for macular degeneration is aging, and so, with more females being alive later in years, they probably have a higher prevalence of this disease in comparison to their male [counterparts].”

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MD Newsline:

Are there lifestyle and environmental factors that increase one’s risk of developing wet AMD? 

Dr. Rishi Singh:

“You know, whenever we talk to a patient about macular degeneration, we talk about lifestyle modifications. What that means for most patients is making sure they’re eating a diet full of green leafy vegetables [and] a dose of fish every few days. Oily fish, in particular with high omega-3s, are supposed to be beneficial.

The green leafy vegetables are for the carotenoids that we think are beneficial for macular luteal pigment in retina, in making sure that we give them a high dose of antioxidants either through multivitamins or through these vegetables, to prevent oxidative stress and damage which occur with the process of aging.

In addition, we’ve found that talking to our patients about smoking cessation can really reduce their progression to age-related macular degeneration. And even if you’re a current smoker, if you just quit within a short period of time, I think it’s about 5 years or 7 years, your risk of developing AMD is as much as if you didn’t smoke at all.

So, I think the ability for patients to understand that there are things they can do from a risk-standpoint to help with that is important. Some people talked about sunlight exposure or other factors regarding UVA or UVB light. There’s really no evidence right now that sunlight exposure or increased exposure to UVA or UVB light can cause these conditions to occur.”

 

Responses have been condensed and lightly edited.

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