Pharmacogenetics and nutritional supplementation in age-related macular degeneration

Abstract

Blake M Hampton, Jaclyn L Kovach, Stephen G Schwartz Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA Abstract: The Age-Related Eye Disease Study (AREDS) recommended treatment with antioxidants plus zinc in patients with intermediate or advanced age-related macular degeneration in order to reduce progression risks. Recent pharmacogenetic studies have reported differences in treatment outcomes with respect to variants in genes for CFH and ARMS2, although the treatment recommendations based on these differences are controversial. Different retrospective analyses of subsets of patients from the same AREDS trial have drawn different conclusions. The practicing clinician, who is not an expert on genetics, clinical trial design, or statistical analysis, may be uncertain how to interpret these results. Based on the balance of the available literature, we suggest not changing established practice recommendations until additional evidence from clinical trials becomes available. Keywords: Age-Related Eye Disease Study (AREDS), age-related macular degeneration, age-related maculopathy susceptibility 2 (ARMS2), complement factor H (CFH), pharmacogenetics, randomized clinical trial (RCT)