Blindness prevention possible with lifestyle changes

Timely lifestyle changes can protect people at high risk of age-related macular degeneration (AMD) from vision loss into old age. This is a key intermediate result of the European research project EYE-RISK.

Number of AMD cases could be halved by 2030

Timely lifestyle changes can protect people at high risk of age-related macular degeneration (AMD) from vision loss into old age. This is a key intermediate result of the European research project EYE-RISK.

The Germany-based PRO RETINA patient organization explained who is particularly at risk of age-related macular degeneration (AMD), how the individual risk profile is determined and which three lifestyle factors are decisive in prevention.

Besides genetic predisposition, being over 60 years old is one of the greatest risks for AMD. AMD is the most common cause of blindness in old age in western countries. With increasing life expectancy, the number of people affected and, above all, the number of those most severely affected is constantly increasing.

While wet AMD can be treated to a limited extent, there is no effective therapy for dry AMD. This is where the European research project EYE-RISK comes in. The consortium brings together 14 partners from eight EU countries - including clinics, research institutes, two companies and the patient organization PRO RETINA - to identify people with a high risk of AMD at an early stage, to better understand the disease mechanisms and to develop new therapies.

World's largest database for AMD

For this purpose, EYE-RISK systematically evaluated data from 60,000 affected people using computer simulation and artificial intelligence methods. "This database is currently the world's largest knowledge resource for AMD," said Professor Dr. Marius Ueffing from the Research Institute of Ophthalmology at Tübingen University Hospital, who coordinated the EU project. The European Union-funded EYE-RISK, a network of researchers in the fields of epidemiology, clinics, genetics, molecular and cell biology, computer sciences, pharmacology, and diagnostics development, with six million euros for a period of four years.

By analyzing the large pool of data, the researchers involved have succeeded in identifying highly effective factors that protect against AMD. "Those who give up smoking, eat Mediterranean food and exercise daily can significantly improve their chances of maintaining their vision into old age despite a high genetic risk profile," Ueffing summarised. The data show that AMD develops much more slowly in people who live like this. "In the best case, AMD does not develop into a late form at all, the affected persons can continue to drive or read and thus lead an independent life," explains EYE-RISK coordinator Ueffing.

Nicotine abstention, plenty of vegetables and fish, 6,000 steps a day

In concrete terms, the diet should include little industrially processed food, but plenty of fresh, vitamin-rich vegetables. Fish, olive oil and omega-3 fatty acids, optionally also in the form of fish oil capsules, protect if this is a regular component of the diet over a longer period of time. There are also specific instructions for physical activity as a protective lifestyle factor. "For an older person, 5,000 to 6,000 steps per day are recommended, i.e. a walk of about one hour," says Ueffing. Alternatively, a sporting activity appropriate to the age can also help.

People whose close relatives suffer from a retinal disease are particularly at risk of developing AMD. "In this case, you should go to an ophthalmologist once a year from the age of 50 and be examined for deposits in the back of the eye, so-called ‘drusen’," advised Ueffing. If the ophthalmologist detects such fat and protein deposits, the time has come to change the lifestyle consistently. "Once cell death has started in the eye, the process can only be delayed," warned Ueffing. Anyone who sees distorted lines on tiles or on an empty sheet of calculation paper should consult an ophthalmologist immediately.

Individual tests for risk and course

In addition to the prevention strategy, EYE-RISK has developed an analytical and diagnostic panel that can predict the disease risk and course of an individual with relative reliability. "To this end, more than 40 individual pieces of information from age, lifestyle, clinical data, and an eye examination are initially recorded, and in a second step the genetic risk profile is tested," continued Ueffing. The DNA test is currently being performed by the Dutch University of Nijmegen on the basis of a blood sample. Computer algorithms analyze and evaluate all the data obtained.

"We are convinced that it will be possible to halve the number of people blinded by AMD by 2030," said Ueffing. He also assumes that dry AMD will be treated in fifteen years: "Therefore, a time gain through lifestyle adjustments is an invaluable advantage.” To achieve this, the knowledge that has been gathered until this point must reach physicians’ practices and clinics. This is what a future EYE-RISK project would like to achieve.