Serum Cholinesterases as Indicators of Cholinergic Dysfunction in Exudative Age-Related Macular Degeneration

The aim of this study was to measure serum acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activities in order to evaluate the potential role of the cholinergic system in exudative type age-related macular degeneration (AMD).

This case-control study involved 38 individuals diagnosed with exudative AMD and 41 healthy individuals with similar characteristics in terms of age and gender. The Ellman method was used to evaluate serum AChE and BChE activity after each subject underwent an ophthalmological examination. Multivariate logistic regression, ROC curve analysis, t-tests, and Mann-Whitney U tests were used in the statistical studies.

Serum AChE activity levels were higher in the AMD-diagnosed group compared to the control group (1.155 ± 0.178 µmol/mL vs. 1.029 ± 0.150 µmol/mL; p = 0.002). There was no statistically significant difference in BChE activity levels (p = 0.24). AChE activity showed moderate diagnostic performance according to ROC analysis (AUC = 0.697; 95% CI: 0.580-0.814; optimal threshold ≥1.106 µmol/mL; sensitivity 63.2%; specificity 70.7%). According to logistic regression analysis, AChE activity levels were considered an independent predictor of AMD (OR = 89.34; p = 0.005).

The increased serum AChE activity observed in exudative AMD suggests that the cholinergic system plays a role in retinal degeneration. AChE levels could be considered as potential AMD pathogenesis biomarkers and as a potential treatment target.