Serum cholesterol efflux capacity is higher in patients with early age-related macular degeneration (eAMD) and polypoidal choroidal vasculopathy (PCV) compared with those with other forms of the condition and healthy controls, according to a study published in Ophthalmology Science.  

Investigators included 422 serum samples representing 80 patients with eAMD and 232 patients with neovascular age-related macular degeneration (nAMD). Among the nAMD arm, 80 patients had typical neovascular age-related macular degeneration (tAMD) and 152 had PCV. Researchers matched these participants with 110 age and gender controls. They determined the relationship between cholesterol efflux capacity and the lipid subfractions in the experimental cases and controls.

The researchers found that serum cholesterol efflux capacity levels were higher in the eAMD and PCV groups compared with healthy controls and individuals with tAMD (68.0%, 75.9%, 56.9%, and 60.5%, respectively). Small, medium, and large high density lipoproteins (HDLs) were moderately associated with cholesterol efflux capacity in patients with eAMD and PCV. Increased rates of cholesterol efflux were moderately correlated with higher HDL composition, although this association does not explain higher rates.

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“Our results indicate that small, medium and large HDLs, among all lipids, play important roles in the pathogenesis of early AMD and PCV,” according to the researchers. They assert that the investigation is a “first step toward understanding the diverse role of HDL.”

Study limitations include the inclusion of hospital- and population-based cohorts, which could lead to selection bias, confounding due to patient medications, and obtaining blood samples during non-fasting conditions. 


Yanagi Y, Yu RMC, Ahamed W, et al. Serum cholesterol efflux capacity in age-related macular degeneration and polypoidal choroidal vasculopathy. Ophthalmol Sci. Published online March 15, 2022. doi:10.1016/j.xops.2022.100142