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Systemic Complement Activation Profiles in Nonexudative Age-Related Macular Degeneration: A Systematic Review
Jonathan B Lin1, Stylianos Serghiou2, Joan W Miller1
1Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
Ophthalmology Science
|May 26, 2022
Summary
Systemic complement activation is elevated in patients with age-related macular degeneration (AMD) and geographic atrophy (GA). This suggests complement overactivation is a feature of AMD, but more research is needed due to study heterogeneity.
Area of Science:
- Ophthalmology
- Immunology
- Genetics
Background:
- Complement inhibition is a therapeutic strategy for geographic atrophy (GA), but results are mixed.
- Dysregulation of the complement pathway in age-related macular degeneration (AMD) is not fully understood.
- Previous studies on systemic complement activation in AMD have conflicting interpretations due to varying methodologies.
Purpose of the Study:
- To determine if systemic complement activation profiles differ between patients with early to intermediate nonexudative AMD or GA and control individuals.
- To clarify the role of complement dysregulation in the pathogenesis of AMD.
Main Methods:
- A systematic review of studies published up to October 2020 was conducted.
- Searched databases included PubMed, Google Scholar, and Embase.
- Risk of bias was assessed using a modified Newcastle-Ottawa score.
Main Results:
- Eight studies involving 2131 participants were reviewed.
- Patients with early and advanced nonexudative AMD showed higher systemic levels of complement activation products.
- These patients also exhibited lower systemic levels of complement inhibition products compared to controls.
Conclusions:
- Systemic complement overactivation appears to be a characteristic of early, intermediate, and advanced nonexudative AMD.
- Significant heterogeneity among studies indicates findings are not conclusive.
- Further investigation is warranted to confirm these observations and their clinical implications.
