Malnutrition Associated with Early-stage AMD

This retrospective study revealed a progressive decline in nutritional status from the control group to AMD to AMD-RPD. Patients with AMD and AMD-RPD also had significantly reduced choroidal vascular index compared to controls, indicating that poorer nutritional status is associated with lower CVI. The above chart from the study shows the positive predictive value all three scores showed in distinguishing the AMD-RPD group from the control group, particularly GNRI and PNI. Photo: Guo S, et al. Transl Vis Sci Technol. 2025;14(12):25. Click image to enlarge. Nearly one in four adults aged 65 or older is malnourished or at risk of malnutrition, which is a key contributor to chronic inflammation and a crucial pathogenic mechanism in the progression of age-related macular degeneration (AMD). Since nutrition is a modifiable risk factor for AMD, tackling malnutrition along with its related inflammatory responses might be a promising approach for managing the disease. In a new study, researchers investigated the correlations between malnutrition, choroidal parameters and early-stage AMD, particularly the reticular pseudodrusen (RPD) phenotype, which is strongly linked to late-stage AMD. Its authors identified two nutritional scores that may help identify patients at higher risk of RPD.The retrospective study, published recently in Translational Vision Science & Technology, involved 177 participants aged 55 years or older, recruited from a large hospital in China. Patients were categorized into three distinct groups based on their ocular health status: control (54 eyes), AMD (55 eyes) and AMD with RPD (68 eyes). The researchers conducted comprehensive fundus imaging and bloodwork to assess nutritional status through three validated scoring systems: the Controlling Nutritional Status (CONUT) score, the Geriatric Nutritional Risk Index (GNRI) and the Prognostic Nutritional Index (PNI). These scoring systems considered various biochemical markers such as serum albumin levels and lymphocyte counts, which are indicative of overall nutritional well-being and inflammation pathways associated with AMD.The results revealed a high prevalence of malnutrition and poor nutritional status among individuals with AMD, especially in those exhibiting the RPD phenotype. Patients with AMD or AMD-RPD had significantly lower nutritional scores than controls in all three scoring systems. Notably, individuals in the AMD-RPD category showed much lower GNRI and PNI scores compared to those with conventional AMD, asserting the predictive value of these tools.Beyond correlational data, the study also found a significant positive relationship between choroidal vascular index and both GNRI and PNI scores, highlighting the adverse effects of underlying nutritional deficiencies on choroidal health and, consequently, AMD progression.The researchers identified specific cutoff values for each nutritional score to distinguish individuals with AMD: 1.5 for CONUT, 101.508 for GNRI and 51.275 for PNI. For differentiating the RPD phenotype from AMD, they identified cutoff values of 97.659 for GNRI and 48.525 for PNI.“Given that the RPD phenotype is strongly associated with accelerated progression to late-stage AMD and various systemic diseases, identifying individuals below these thresholds provides a valuable opportunity for timely intervention,” the researchers noted in their paper. They concluded, “From a clinical perspective, dieticians may consider referring such individuals” for prompt ophthalmologic evaluation, whereas ophthalmologists may integrate these nutritional scores to obtain a more comprehensive assessment of patients’ nutritional profiles, thereby enabling effective follow-up and fostering collaboration with nutrition specialists in AMD management.”Click here for the journal source. Guo S, Gao L, Cao D, et al. The prevalence of malnutrition and early-stage age-related macular degeneration: using three nutritional scoring systems. Transl Vis Sci Technol. 2025;14(12):25.  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.