Does apolipoprotein E polymorphism play a role in age-related macular degeneration?

Purpose. As apolipoprotein E polymorphism is both a codeterminant of atherosclerotic susceptibility and important for neuronal repair, we evaluated the association between apolipoprotein E genotype and age-related macular degeneration. Methods. The apolipoprotein E genotype was determined in 101 subjects with AMD and 823 randomly selected controls, both derived from the population-based Rotterdam Study The diagnosis of atrophic and neovascular was based on grading of fundus transparencies. The risk of macular degeneration was evaluated in a stratified analysis on apolipoprotein E genotype. Results. The frequency of the apolipoprotein E allele ε4 was lower in subjects with macular degeneration than in controls (5.9.% vs 15.7%, p < 0.05). Subjects with the apolipoprotein E genotype E3E4 showed a considerably lower risk of macular degeneration than did subjects with the wild type genotype E3E3 (relative risk 0.32, 95% CI 0.15-0.69). This association was irrespective of age and similar for both types of AMD. Conclusions. Apolipoprotein E may either be an important susceptibility factor in the etiology of age-related macular degeneration or it may be in linkage disequilibrium with this disease.