Risk of age-related macular degeneration: population-attributable fractions in 600 000 individuals without genetic information or baseline ocular phenotypes from two contemporary population-based studies
Year: 2026
Type: article
Abstract: Objectives To determine absolute risks and population-attributable fractions for risk factors for neovascular and any age-related macular degeneration (AMD) in individuals without genetic information or baseline ocular phenotypes, and to define high-risk profiles for neovascular and any AMD.Methods and analysis In a total of 109 163 individuals (1315 incident neovascular AMD cases) in the Copenhagen General Population Study (CGPS) and 501 255 (10 419 incident any AMD cases) in the UK Biobank, we calculated HRs, 10-year cumulative incidences for absolute risk and population-attributable fractions for risk factors for neovascular and any AMD. High risk profiles were defined using the four risk factors with the highest population-attributable fractions.Results We identified eight concordant modifiable risk factors for neovascular AMD in CGPS and any AMD in UK Biobank: smoking, high alcohol intake, low physical activity, C-reactive protein >2 mg/L, low-density lipoprotein cholesterol ≤3 mmol/L, high high-density lipoprotein cholesterol (≥1.94 mmol/L in CGPS; ≥1.67 mmol/L in UK Biobank (≥4th quartile)), cataract surgery and diabetes. Their population-attributable fractions were 42% in CGPS and 24% in UK Biobank. Sensitivity analyses suggested possible confounding or reverse causation for cataract surgery. The risk profile comprising smoking, high alcohol intake and C-reactive protein >2 mg/L in women was associated with HRs of 2.58 (95% CI 1.70 to 3.92) for neovascular AMD in CGPS and 1.91 (1.63 to 2.24) for any AMD in UK Biobank compared with those with none of the risk factors.Conclusions In individuals without genetic information or baseline ocular phenotypes, eight modifiable risk factors were associated with both neovascular and any AMD in two population-based cohorts and may explain 42% of neovascular AMD cases and 24% of any AMD cases in the population representing possible targets for future prevention trials. Our risk profiles based on commonly available clinical parameters may assist in identifying high-risk individuals in primary care for further clinical follow-up.
Source: BMJ Open Ophthalmology
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,085
OpenAlex ID: W7225333566