1. Introduction
AMD, vision loss, blindness
MACULAR DEGENERATION, BLINDNESS, DISEASE, AGE-RELATED MACULAR DEGENERATION, PATHOGENESIS
The AMD-Life team, members are summarized in the supplementary material.These authors contributed equally to this work.Age-related macular degeneration (AMD) has a strong genetic basis, but environmental factors such as smoking and a healthy diet can decrease the genetic fate by up to 50%. Current guidelines for clinical management include recommendations for a healthy lifestyle and antioxidant supplementation. However, many ophthalmologists do not inform their patients of this AMD-beneficial lifestyle. An important reason is the lack of trust that transition of lifestyle will be feasible in persons of advanced age and lack of methodology to measure lifestyle or its biological effects. To address these issues, we set up the lifestyle intervention study AMD-Life. It aims to investigate whether personalized risk-profiling (including genetic testing) and/or additional coaching can motivate patients to change their lifestyle. It also explores which biomarkers best reflect lifestyle change beneficial for AMD. The first year is a three-arm, self-contained open-label randomized clinical trial. A total of 150 AMD patients aged 55–85 years were randomized into three arms: (A) merely standard recommendations; (B) A conditions plus personalized risk profiling based on genetics and lifestyle, (C) B conditions plus coaching. The second year tests sustainability of lifestyle changes without active intervention. AMD-Life can provide further insight into the relevance of these interventions for the clinical management of AMD.Age-related macular degeneration (AMD) is a leading cause of blindness in the elderly of the Western world. Currently, more than 196 million people worldwide have AMD, and global aging will increase the number of affected persons to 288 million by the year 2040 [The genetic architecture of AMD has been mostly uncovered. Several years ago, a large genome-wide association study reported association with 52 common genetic variants in 34 loci [Environmental factors also play a significant role in disease pathogenesis; in particular, smoking [Most preferred practice patterns for AMD recommend lifestyle measures, but the information provided to patients and adherence tend to be poor. Up to 60% of patients do not take oral supplements or use them incorrectly, and smoking cessation or long-term dietary changes are often not achieved [In the current AMD-Life trial, we aim to investigate which strategy is most successful in motivating patients to change the behavior that is driving them to vision loss: receiving only general information on risks and benefits, receiving detailed information about personalized risks and targets for change, or receiving coaching based on behavioral change technique (BCT) [