Objective:
To identify systemic complement factors associated with the progression from intermediate age-related macular degeneration (iAMD) to advanced stages, highlighting their potential clinical significance.
Key Findings:
- 34% of patients progressed to advanced AMD over a mean follow-up of 3.9 years, with 24-month biomarker data showing moderate to good discrimination between progressors and nonprogressors.
- Lower systemic levels of C3 and C5 were associated with disease progression.
- C3a/C3 and C5a/C5 ratios were significantly linked to progression to geographic atrophy (GA).
- No complement factor reached statistical significance for association with progression to neovascular AMD (nAMD).
Interpretation:
The study highlights the potential role of systemic complement biomarkers in identifying iAMD patients at elevated risk for progression, emphasizing the need for further exploration of the classical pathway in AMD research and its clinical implications.
Limitations:
- Sample attrition may affect results.
- Exact timing of progression remains undetermined, which could influence treatment decisions.
- Limited statistical power for distinguishing between GA and nAMD outcomes.
Conclusion:
The findings suggest that complement dysregulation may serve as both a risk marker and a therapeutic target, potentially leading to new bioassays and therapies for AMD, which could significantly impact patient management.
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