Dietary, environmental, and genetic risk factors of Extensive Macular Atrophy with Pseudodrusen, a severe bilateral macular atrophy of middle-aged patients

Aymeric Douillard 1, 2 Marie-Christine Picot 1, 2 Cécile Delcourt 3 Sabine Defoort-Dhellemmes 4 Nour Al-Dain Marzouka 5, 6, 7 Annie Lacroux 5, 1, 7 Xavier Zanlonghi Isabelle Drumare 4 Elsa Jozefowicz 4, 8 Béatrice Bocquet 5, 6, 7 Corinne Baudoin 5, 1, 7 Sarah Perez-Roustit 5, 6, 7 Sophie Arsène Valérie Gissot François Devin Carl Arndt 9 Benjamin Wolff Martine Mauget-Faÿsse 10 Maddalena Quaranta Thibault Mura 2 Dominique Deplanque 11 Hassiba Oubraham Salomon Yves Cohen 12 Pierre Gastaud Olivia Zambrowski Catherine Creuzot-Garcher 13 Saddek Mohand Saïd 14, 15 José-Alain Sahel 16 Eric Souied 17 Solange Milazzo Rocio Blanco Garavito Vasiliki Kalatzis 5, 7 Bernard Puech 4 Christian Hamel 5, 1, 7 Isabelle Audo 16, 18 Isabelle Meunier 5, 1, 7
1 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
2 CIC Montpellier
3 BPH - Bordeaux population health
4 CHRU Lille - Centre Hospitalier Régional Universitaire [Lille]
5 INM - Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs
6 UM - Université de Montpellier
7 Centre de référence des affections sensorielles d'origine génétique
8 Université de Lille
9 CHU Reims - Centre Hospitalier Universitaire de Reims
10 Fondation Ophtalmologique Adolphe de Rothschild [Paris]
11 CIC Lille
12 CHI Créteil
13 Service d'Ophtalmologie (CHU de Dijon)
14 CNRS - Centre National de la Recherche Scientifique
15 Sorbonne Universités
16 Institut de la Vision
17 CHIC - Centre Hospitalier Intercommunal de Créteil
18 CIC Quinze-Vingts
Abstract : EMAP (Extensive Macular Atrophy with Pseudodrusen) is a maculopathy we recently described that shares pseudodrusen and geographic atrophy with Age-related Macular Disease (AMD). EMAP differs from AMD by an earlier age of onset (50-55 years) and a characteristic natural history comprising a night blindness followed by a severe visual loss. In a prospective case-control study, ten referral centers included 115 EMAP (70 women, 45 men) patients and 345 matched controls to appraise dietary, environmental, and genetic risk factors. The incidence of EMAP (mean 2.95/1.106) was lower in Provence-Côte d'Azur with a Mediterranean diet (1.9/1.106), and higher in regions with intensive farming or industrialized activities (5 to 20/1.106). EMAP patients reported toxic exposure during professional activities (OR 2.29). The frequencies of common AMD complement factor risk alleles were comparable in EMAP. By contrast, only one EMAP patient had a rare AMD variant. This study suggests that EMAP could be a neurodegenerative disorder caused by lifelong toxic exposure and that it is associated with a chronic inflammation and abnormal complement pathway regulation. This leads to diffuse subretinal deposits with rod dysfunction and cone apoptosis around the age of 50 with characteristic extensive macular atrophy and paving stones in the far peripheral retina.
Keywords : Humans Female Male Retrospective Studies Adult Aged Middle Aged Genetic Predisposition to Disease Case-Control Studies France Risk Factors Prospective Studies Environmental Exposure Feeding Behavior Geographic Atrophy Diet Mediterranean Retinal Drusen
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Journal articles
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https://hal.archives-ouvertes.fr/hal-02349434
Contributor : Pascale Roussel <>
Submitted on : Tuesday, November 5, 2019 - 4:27:28 PM
Last modification on : Thursday, November 7, 2019 - 1:41:34 AM

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Aymeric Douillard, Marie-Christine Picot, Cécile Delcourt, Sabine Defoort-Dhellemmes, Nour Al-Dain Marzouka, et al.. Dietary, environmental, and genetic risk factors of Extensive Macular Atrophy with Pseudodrusen, a severe bilateral macular atrophy of middle-aged patients. Scientific Reports, Nature Publishing Group, 2018, 8 (1), pp.6840. ⟨10.1038/s41598-018-25003-9⟩. ⟨hal-02349434⟩

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