Comorbidities with Macular Degeneration

Macular degeneration has been linked to multiple conditions. In some cases, the connection is clear, but in many cases, only a correlation has been identified.

General

Age-related macular degeneration in general has been shown to be linked to higher incidence of:

• Systemic conditions such as hypertension, coronary artery disease, cerebrovascular disease, chronic respiratory diseases, cardiac dysrhythmias, hyperlipidemia, osteoporosis, diabetes, cirrhosis, chronic kidney disease
• Cognitive decline – Patients with AMD have a 1.23-fold increased risk of developing Alzheimer’s disease.
• Mental and Social Health conditions such as depression, isolation, and unresolved grief.
• Charles Bonnet syndrome Some people with AMD experience Charles Bonnet syndrome, which causes visual hallucinations 

Other factors associated with AMD include smoking, gout, cataract, and cancer. 

Drusen

The presence of drusen, yellow fat deposits behind the retina, is most often associated with macular degeneration (both age-related and Stargardt), but has also been linked to higher incidence of Alzheimer’s¹, genetic conditions such as Sorsby fungus dystrophy, North Carolina macular dystrophy, and Adult-onset foveomacular vitelliform dystrophy. Additionally, drusen has been associated with a few systemic conditions like dense deposit disease and Alport syndrome. ²

Dry Macular Degeneration

Dry macular degeneration, sometimes referred to as “early stage” age-related macular degeneration has been linked to higher incidence of Alzheimer’s Disease.

Wet Macular Degeneration

Wet macular degeneration (also called neovascular age-related macular degeneration) has been linked to higher incidence of migraines (people with migraines have a 20% higher chance of developing neovascular age-related macular degeneration³

Geographic Atrophy

Geographic Atrophy is the advanced form of dry age-related macular degeneration, and is linked to higher incidence of:

• Diabetes
• Coronary heart disease
• High blood pressure
• High cholesterol
• Obesity

Stargardt Disease

Stargardt Disease is the juvenile form of macular degeneration, and while it leads to similar peripheral vision loss, the causes of stargardt disease are different from age-related macular degeneration.

Stargardt disease is linked to loss of gray matter. Exact causes are, to date, unknown, but it is suspected that at least some of the alterations are due to visual deprivation.⁴

1. Smilnak GJ, Deans JR, Doraiswamy PM, Stinnett S, Whitson HE, Lad EM. Comorbidity of age-related macular degeneration with Alzheimer’s disease: A histopathologic case-control study. PLoS One. 2019 Sep 30;14(9):e0223199. doi: 10.1371/journal.pone.0223199. PMID: 31568508; PMCID: PMC6768473. ↩︎
2. VanDenLangenberg AM, Carson MP. Drusen Bodies. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559087/# ↩︎
3. Kuang, TM., Xirasagar, S., Kao, YW. et al. Association of neovascular age-related macular degeneration with migraine. Sci Rep 12, 1792 (2022). https://doi.org/10.1038/s41598-022-05638-5 ↩︎
4. Gaia Olivo, Paolo Melillo, Sirio Cocozza, Francesco Maria D’Alterio, Anna Prinster, Francesco Testa, Arturo Brunetti, Francesca Simonelli, Mario Quarantelli; Cerebral Involvement in Stargardt’s Disease: A VBM and TBSS Study. Invest. Ophthalmol. Vis. Sci. 2015;56(12):7388-7397. https://doi.org/10.1167/iovs.15-16899. ↩︎