SYSTEMATIC REVIEW article
Front. Med.
Sec. Ophthalmology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1544765
Identification of risk factors for the progression of age-related macular degeneration: A systematic review and meta-analysis of cohort studies
Provisionally accepted
Moqi Tian1
Baike Zhang2*- 1Henan University of Chinese Medicine School of Medicine, Zhengzhou, China
- 2No. 988th Hospital of Joint Logistic Support Force of PLA, Zhengzhou, China
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Background: Age-related macular degeneration (AMD) is a retinal degenerative disease that primarily affects the elderly population and is a leading cause of vision loss in older adults. There is a lack of research comprehensively examining the risk factors for AMD progression. This study aimed to identify the risk factors influencing the development of AMD using a meta-analysis approach. Methods: We systematically searched the PubMed, Embase, and Cochrane Library databases from their inception until November 2024. Summary effect estimates were assigned as odds ratios (ORs) with 95% confidence intervals (CIs) using a random effects model. Further exploratory analyses included sensitivity and sub-group analyses. Results: Eighteen cohort studies involving 38,697 individuals were included in the final meta-analysis. We noted male versus female was associated with a reduced risk of AMD (OR: 0.84; 95% CI: 0.72–0.98; P = 0.027). The identified risk factors for AMD included per 5-year increment in age (OR: 1.14; 95% CI: 1.09–1.19; P < 0.001), current smoking (OR: 1.28; 95% CI: 1.07–1.52; P = 0.007), alcohol intake (OR: 1.30; 95% CI: 1.00–1.67; P = 0.046), per 1 mmol/L increment in high-density lipoprotein (OR: 1.21; 95% CI: 1.08–1.36; P = 0.001), total drusen >10% of the grid (OR: 7.85; 95% CI: 4.66–13.23; P < 0.001), presence of depigmentation (OR: 6.39; 95% CI: 2.48–16.44; P < 0.001), presence of hyperpigmentation (OR: 6.03; 95% CI: 1.94–18.73; P = 0.002), and >10 small drusen (OR: 7.21; 95% CI: 2.10–24.72; P = 0.002). Conclusion: This study systematically identified the risk factors for AMD progression, and exploratory analyses were performed to determine the risk factors for early and late AMD. Patients at high risk of AMD should be monitored to improve modifiable risk factors and slow the progression of AMD.
Keywords: age-related macular degeneration, Risk factors, progression, Systematic review, Meta-analysis
Received: 13 Dec 2024; Accepted: 07 Jul 2025.
Copyright: © 2025 Tian and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Baike Zhang, No. 988th Hospital of Joint Logistic Support Force of PLA, Zhengzhou, China
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