Macular degeneration, also known as ARMD, is a retinal disease that typically affects both eyes. It is not a disease that has typical inheritance patterns, yet there is a racial bias for developing the disease. Also, certain habits, such as smoking, seem to increase the risk.
Are you at risk for developing the disease?
Northern European Ancestry
Typically, patients of northern European heritage, aka Caucasians, develop more macular degeneration compared to blacks or Asians. Most of my patients with dry macular degeneration are usually Caucasian. The blacks and Asians that I diagnose with ARMD usually have the wet form. Again, this is in my practice.
Patients with Blue Eyes
Originally, patients with blue eyes were deemed at higher risk. While there may be a statistical association, I think it’s also possible that those individuals with the lightest complexion have blue eyes, too.
Smoking Must be Bad for Your Eyes
There is definitely an association with the wet form of macular degeneration and smoking, especially in Caucasian patients. We don’t know; however, the exact cause (i.e. how does smoking cause the disease?).
Younger Patients Don’t Get the Disease
I hesitate to make the diagnosis of ARMD in patients younger than 55. Patients younger than 55 can get macular disease, but it may behave differently than typical ARMD.
Patients with Drusen
I get questions all the time about drusen and the risk for developing eye disease. Drusen can be normal. Not all drusen constitute the diagnosis of macular degeneration.
Twins and Siblings of Affected Patients?
More than anything, as an observer, I don’t feel that the eye disease runs in families, that is, it doesn’t follow usual inheritance patterns. It is quite possible for you to contract the disease, but your twin does not. Just because your mom or dad had the disease doesn’t mean you’ll get it.
What Does This Mean? Someday we’ll find that “macular degeneration” is actually a collection of diseases that look and behave similarly, but for now we are unable to distinguish between them. Thus, it is difficult to characterize the disease.
There does seem to be certain risk factors that make us more susceptible to developing ARMD. Certainly if smoking were the only risk factor, the disease would be more evenly dispersed amoung races, that is, the disease would be similar to the prevalence of smoking in a particular race. Clearly, this is not the case, so there must be a risk factor for developing the disease if we smoke.
There must also be, but yet to be proven, a protective effect of diet. We’ll see with AREDS II.
For now, we think we’ve identified those attributes that increase our risk for macular degeneration. Until we can predict who will develop the disease, get regular dilated eye exams if you are concerned.
The disease may not be truly inherited, but the risk factors might be.
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
Fairfax, Virginia