A prospective study of 2 major age-related macular degeneration susceptibility alleles and interactions with modifiable risk factors

Arch Ophthalmol. 2007 Jan;125(1):55-62. doi: 10.1001/archopht.125.1.55.


Objectives: To delineate the magnitude of susceptibility to age-related macular degeneration (AMD) due to common variants in the gene for complement factor H (CFH) and the predicted gene LOC387715 and to determine whether these variants interact with modifiable risk factors.

Methods: We compared cases who developed AMD (n = 457) with 1071 age- and sex-matched control subjects in a prospective nested case-control study within the Nurses' Health Study and the Health Professionals Follow-up Study. We determined the incidence rate ratios and 95% confidence intervals (CIs) for AMD for each genotype and examined the interactions with modifiable risk factors.

Results: Participants with 1 or 2 copies of the Y402H variant of CFH were, respectively, 1.98 (95% CI, 1.64-2.40) and 3.92 (95% CI, 2.69-5.76) times more likely to develop AMD, whereas the incident rate ratios (95% CIs) for 1 and 2 copies of LOC387715 A69S were 2.38 (1.92-2.96) and 5.66 (3.69-8.76), respectively. The fraction of AMD cases attributable to these 2 variants was 63% (95% CI, 58%-68%). Subjects homozygous for both risk alleles had a 50-fold increased risk of AMD (95% CI, 10.8-237), and cigarette smoking and obesity multiplied the risks associated with these variants.

Conclusion: Age-related macular degeneration has emerged as a paradigmatic example of a common disease caused by the interplay of genetic predisposition and exposure to modifiable risk factors.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Alleles*
  • Case-Control Studies
  • Complement Factor H / genetics
  • Female
  • Genetic Predisposition to Disease*
  • Health Personnel
  • Humans
  • Macular Degeneration / genetics*
  • Male
  • Middle Aged
  • Obesity / complications
  • Polymorphism, Single Nucleotide / genetics
  • Prospective Studies
  • Risk Factors
  • Smoking / adverse effects


  • CFH protein, human
  • Complement Factor H