The Prevalence of Malnutrition and Early-Stage Age-Related Macular Degeneration: Using Three Nutritional Scoring...

To investigate the interrelationships among malnutrition, choroidal parameters, and early-stage age-related macular degeneration (AMD), particularly the reticular pseudodrusen (RPD) phenotype, and to assess the predictive value of three nutritional scores.

A total of 177 eyes were included in the study, categorized into control (n = 54), AMD (n = 55), and AMD-RPD (n = 68) groups based on fundus features. Nutritional status was assessed using the Controlling Nutritional Status (CONUT) score, Geriatric Nutritional Risk Index (GNRI), and Prognostic Nutritional Index (PNI). Choroidal vascular index (CVI) and choroidal thickness (ChT) were measured.

Nutritional scores indicated a progressive decline in nutritional status from control to AMD to AMD-RPD. Compared with the control group, both AMD and AMD-RPD individuals had significantly worse CONUT, GNRI, and PNI scores (all P ≤ 0.01). Compared with the AMD group, AMD-RPD had significantly lower GNRI and PNI scores (both P < 0.001). CVI was positively correlated with GNRI (r = 0.308, P < 0.001) and PNI (r = 0.284, P < 0.001). The predictive value of all three nutritional scores for both AMD and AMD-RPD was demonstrated, with GNRI and PNI showing utility in differentiating RPD from AMD.

Malnutrition is associated with early-stage AMD phenotypes and choroidal vascular abnormalities may underlie this link. GNRI and PNI may help identify high-risk RPD individuals and support early nutritional assessment and intervention.

Integrating these nutritional scores may enhance collaboration between ophthalmologists and dietitians, enabling better detection and management of AMD and RPD in clinical practice.