Challenges and Opportunities in Systemic Biomarkers for Age-related Macular Degeneration

Blood biomarkers have been widely used in medicine for the prevention, diagnosis, and treatment follow-up of many diseases. Age-related macular degeneration, the main cause of irreversible blindness in old age, does not benefit from these important indicators. In recent decades, technological advances have given us optical coherence tomography. Until a few years ago, this exam was used for the diagnosis, and treatment evaluation of age-related macular degeneration. Currently, as part of multimodal fundus imaging, it has also been used in the prognosis of age-related macular degeneration. However, these exams are still not capable of predicting when individuals may trigger the degenerative macular disease, and consequently adopt preventive measures, such as changes in lifestyle and consumption of antioxidants. In this regard, this article aims to address the various blood biomarkers that may be useful in the early investigation of age-related macular degeneration, even before the appearance of drusen and retinal pigment epithelium changes in the macular region, the first ophthalmoscopic manifestations of age-related macular degeneration. Among these biomarkers analyzed, the blood count, lipid profile, some enzymatic and non-enzymatic antioxidants, as well as the main inflammatory biomarkers, stand out.