AMD Progression

Early Detection for a Personalized Approach

Macula Risk equips eye care professionals to predict disease progression, recommend unique treatment approaches, and protect the sight of their patients.

AMD can be managed more effectively with early detection of progression to wet AMD. With the support of the Macula Risk test, eye care professionals using a scientific approach to predicting the progression of the disease can help prepare their patients for the future.

Questions and Answers about AMD Progression

“I had the genetic test done through Arctic. I discovered I was not zinc sensitive, but I learned about my progression over five and 10 years. Although this has scared me, I was happy to have had the genetic test and use it for monitoring and early treatment. For me it was a positive experience.”

Margaret

Patient, Boston, MA

What is AMD Progression?

AMD progresses through stages, beginning with the appearance of hard deposits (called drusen) in the back of the eye. These deposits grow in size as the disease progresses. About one third of people with Dry AMD eventually get advanced AMD.

AMD progresses through stages, beginning with the appearance of hard deposits (called drusen) in the back of the eye. These deposits grow in size as the disease progresses. About one third of people with dry AMD eventually get advanced AMD.

Early-Stage AMD: Medium-sized drusen deposits with no pigment changes and no loss of vision.

Intermediate AMD: Large drusen or pigment changes. There may be mild vision loss, but most people don’t experience any problems.

Advanced or Late-Stage AMD: Geographic atrophy (GA) or wet macular degeneration that causes vision loss.

Geographic atrophy is an advanced form of age-related macular degeneration that can result in the progressive and irreversible loss of patches of the retina, which can lead to a loss of visual function over time. There are no approved treatments for GA.

Wet AMD, or neovascular (nv) AMD is characterized by abnormal blood vessels growing underneath the retina. (neovascular means new vessels.) These vessels can leak fluid and blood, which may lead to swelling and damage to the macula. Most people with advanced AMD have the wet form of the condition. Wet AMD can be treated.

Further Reading:

Age-related macular degeneration (AMD): Overview. Read More.

How is genetic information from the Macula Risk test used to predict AMD progression?

A person’s inherited genetic profile accounts for 70% of the cause of AMD while the rest is attributed to individual and environmental factors. Measuring genetic variations associated with AMD can be extremely helpful for planning individual management programs. Wet AMD can be managed, but only if patients receive therapy shortly after its appearance. Knowing if an individual is very likely to progress allows for frequent follow-up and other measures to identify this form of advanced disease early.

The Macula Risk test combines the commonly occurring genetic variations (15 genetic variations in 12 genes) associated with the progression of age-related macular degeneration (AMD). The result is integrated into a formula based on research at Tufts Medical Center. Other inputs include a patient’s age, the size of drusen, height, weight, sex, age, and smoking history. This formula provides a basis for estimating individual progression risk.

The Macula Risk report provides a two, five, and 10-year prediction of the risk for progression to the loss of vision from advancing AMD. Published research indicates this test is 89% accurate.

Who should be tested?

All patients with dry AMD should be tested to determine their progression risk as a basis for future treatment.

How will my eye care professional use the Macula Risk report?

Your eye care professional will use the report as one important component of a management plan. Individuals at high risk may have a medical review more frequently than those at lower risk. Early detection and treatment of progression to wet AMD is critical for sight preservation. Even with the best drugs, if treatment is delayed, outcomes are poor.

Those at high risk of progression may also be equipped with home-based equipment used to detect vision loss at the earliest point. Macula Risk provides a scientific basis for decision making related to referrals and treatment options.

What is included in the Macula Risk Report?

The Macula Risk report contains important insights that add to the clinical examination and guides treatment options.

The Macula Risk laboratory report presents the patient’s AMD prognosis and includes the following information:

  • Clinical information (age, sex, smoking history, BMI and AMD status)
  • Genetic results (genotype for 15 AMD-associated genetic markers, and the genetic risk subscore)
  • The patient’s two-, five- and 10-year risk of progression to advanced AMD
  • A recommendation to avoid chronic zinc, if appropriate

Based upon the 10-year risk of progression, the report sorts patients into one of five Macula Risk (MR) categories ranging from MR1 to MR5. Eye care professionals can use these MR scores to personalize disease management programs for their patients.

Research shows that 15% to 20% of patients diagnosed with dry AMD will progress to advanced AMD with vision loss. Macula Risk testing identifies these patients with increased risk (MR3, MR4 and MR5) with 90% accuracy.

What is the science supporting the Macula Risk test?

There are hundreds of publications representing more than 150,000 patients behind the genetic discoveries in Macula Risk. These studies recognize the strong role of genetics in this disease as well as the unmet medical need to detect vision loss earlier for better outcomes. You can read more in our Product Science section.