Gout Patients at Higher Risk of AMD and Disease Progression

Inflammation arising during gout’s pathogenesis may also contribute to ocular inflammatory processes in AMD development. Photo: Better Family Health. Click image to enlarge. In a recent study, researchers examined the association between gout and subsequent development and progression of age-related macular degeneration (AMD). They found that patients with gout with at least one prescription for chronic uric acid therapy had an increased risk for developing dry or wet AMD, macular hemorrhage, and required additional anti-VEGF injections. The findings were reported in Retina.In this retrospective cohort study, data from approximately 120 million patients across 68 US health care organizations in TriNetX were used to identify a gout cohort (patients with idiopathic gout and a prescription for a uric acid-lowering agent) and a control cohort. Propensity score matching was applied to balance baseline demographics and health status, resulting in 16,433 patients in each cohort for the primary analysis.Patients with gout had an increased risk of developing dry AMD (relative risk: 2.73), advanced dry AMD (RR: 2.64), wet AMD (RR: 2.48) and macular hemorrhage, and required anti-VEGF injections (RR: 2.80) at one, three and five years compared with controls.A separate analysis examining those with early dry AMD revealed that patients with gout had an increased risk for early AMD progression to an advanced dry or wet form and developing macular hemorrhage or needed additional anti-VEGF injections at five years when compared with patients with early dry AMD without gout.Whether the treatment of symptomatic or asymptomatic hyperuricemia—a likely mediator between the association of AMD and gout—may lead to improved ocular outcomes among patients with or without AMD remains unclear. “In fact, in vitro studies have supported the notion that uric acid–lowering therapy may reduce toxic effects on the retina among patients with gout, as well as promote retinal recovery,” the authors wrote in their paper.  Additional prospective trials investigating the effects of uric acid lowering therapy on reducing the incidence and progression of AMD among patients with or without gout are necessary, they added.“These findings support previous hypotheses suggesting chronic inflammation in hyperuricemia may play a role in AMD pathogenesis,” the authors concluded in their paper. “Long-term prospective studies evaluating the association between serum uric acid levels and AMD, as well as the benefits of urate-lowering therapy, are necessary.”Click here for the journal source. Alshaikhsalama AM, Alsoudi AF, Wai KM, et al. Gout and risk of age-related macular degeneration. Retina. 2025;45(12):2289-96. [Epub ahead of print.] This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.