Patients with psoriasis are at increased risk of developing age-related macular degeneration (AMD) – a leading cause of vision loss, new research has found.
The findings of a 15-year observational retrospective cohort study of data from the TriNetX collaborative network were exclusively presented at the European Academy of Dermatology and Venereology (EADV) Congress 2025.
The study is among the largest to date to assess whether psoriasis can potentially predispose patients to AMD.
Dermatologist Dr Alison Treichel and her team at the University of Rochester in New York analysed data from 22,901 patients over the age of 55 with psoriasis, and compared their outcomes with three propensity-matched control groups.
The three groups included: individuals with melanocytic nevi to represent other dermatology patients; those who had been diagnosed with major depressive disorder to account for chronic disease and healthcare use; and patients who had undergone an ophthalmologic exam to ensure comparable opportunities for AMD diagnosis.
Patients who had a prior diagnosis of AMD were excluded from the study.
Abnormal lipid dysregulation
Over the 10-year follow up period, individuals with psoriasis had a higher likelihood of developing AMD compared with patients in the major depressive disorder and melanocytic nevi cohorts, with a 56% and 21% increased risk, respectively.
When the team investigated the two main forms of AMD – exudative (wet) and non-exudative (dry) – psoriasis was associated with a 40% and 13% higher risk, compared with the major depressive disorder cohort.
‘Psoriasis is a systemic inflammatory disease in which lipid dysregulation contributes to cardiovascular disease. Abnormal lipid dysregulation in the retina is a hallmark of AMD, particularly the dry form that causes progressive vision loss. It is biologically plausible that psoriasis could increase AMD risk,’ explained Dr Treichel. ‘Our findings support a connection between psoriasis and AMD, both exudative and non-exudative, which could be mediated by shared lipid dysregulation.’
She noted that this study is the first to demonstrate a novel association between psoriasis and non-exudative AMD and serves as a hypothesis generation observation for future studies.
Biologic therapies and AMD risk in psoriasis
Psoriasis patients who were treated with biologic therapies had a 27% lower risk of developing AMD compared with biologic-naive patients who were treated with topical corticosteroids only.
The findings also suggest that biologic therapies could offer protective benefits beyond skin symptoms. ‘Further research is needed to determine whether these treatments have a true disease-modifying effect, and to better understand the role of shared risk factors, including smoking, obesity, cardiovascular disease and access to specialist care,’ Dr Treichel said.
Patients with psoriasis should remain vigilant about the potential risk of developing AMD, she urged. They should continue to follow standard guidelines for eye check-ups and promptly report any changes in their vision to their doctor or specialist. ‘More research is needed before specific screening recommendations can be made,’ she said.
The research team plans to build on the study findings by analysing retinal imaging data from psoriasis patients to better characterise ocular abnormalities, define the prevalence of AMD and evaluate the long-term effects of biologic therapy on disease progression.