What Are the Risk Factors for Age-Related Macular Degeneration

What Are the Risk Factors for Age-Related Macular Degeneration?

• Age. Aging accelerates pathological changes to the macula. As we age, our bodies produce fewer antioxidants to defend against the surge of harmful free radicals that damage organs and tissues, including the macula. Free radical–induced oxidative damage is the culprit in age-related macular degeneration.

• Smoking. Cigarette smoke contains toxic chemicals that enter the bloodstream and travel to the eyes. These harmful chemicals injure blood vessels near the macula. Tar, a toxic chemical from the smoke, enters the retina and causes pathological changes, including to the macula.

• Ultraviolet B. Ultraviolet B radiation from the sun's rays induces a surge of free radical production in the eyes. If unabated, these harmful free radicals can damage the eyes. Although the cornea and lens provide certain shielding protection, ultraviolet radiation can reach the retina and macula at the back of the eye. Excessive sun exposure increases the risk of age-related macular degeneration.

• Cardiovascular disease. Hypertension and atherosclerosis are common in patients with cardiovascular diseases. Hypertension and atherosclerosis damage the blood vessels of the eyes and heighten the risk of age-related macular degeneration.

• Race. People with light-colored eyes and fair skin have a higher risk of age-related macular degeneration compared to people with darker eyes and darker skin.

• Obesity. Obesity is associated with chronic inflammation, hypercholesterolemia, and cardiovascular disease, all of which are risk factors for age-related macular degeneration.

• Lack of exercise. Regular exercise reduces abdominal fat; prevents hypertension, inflammation, and endothelial dysfunction; and boosts "good" cholesterol levels in the blood, thus reducing the risk of age-related macular degeneration. Lack of physical activity increases the risk of age-related macular degeneration in elderly people.

• Hypertension. Hypertension induces the formation of new blood vessels in the choroid layer of the eye, leading to epithelial atrophy in the eyes and increasing the risk of age-related macular degeneration.

• Pathological myopia. Pathological or degenerative myopia is different from ordinary myopia. The former is when an individual is severely nearsighted and has a noticeably elongated eyeball. About 2% of people have pathological myopia in the US. The incidence rates in China, Japan, the Middle East, and Israel are higher than in the US. An elongated eyeball causes a fissure near the bottom of the retina. Frequent bleeding in the fissure region leads to scar formation and growth of new blood vessels. Structural changes to the macula in pathological myopia resemble those in age-related macular degeneration.

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