Personalized Medicine, One Size Does Not Fit All
Personalized medicine identifies an individual’s risk for a disease, like macular degeneration, to help health care providers tailor management and treatment to reduce the risk of development and/or progression of the disease. What is good medicine for one person may not be so good for another. Genetic testing is the first step to personalized medicine.
Studies for the treatment of macular degeneration have yeilded a lot of data on AMD and its progression. Chief among the studies was the Age-Related Eye Disease Study (AREDS) which looked at the affect of vitamin supplementation for those at risk for age related macular degeneration (AMD) and those who had varying degrees of AMD. What they found is that some individuals responded well to vitamin supplementation and others did not respond as well. Many groups of researchers have analyzed the data generated by the AREDS and its follow-up study AREDS 2. The predictor of who goes on AMD progression or wet AMD depends on 3 factors:
- Current level of AMD,
- Genetic Factors, and
- Non-genetic factors (environmental, like general health, smokers, age, and education.)
There are presently two genetic tests available for macular degeneration : Macula Test PGX and Vita Test (Artic) . These tests look at genetic markers on known AMD associated genes. The most significant finding, for why some did not do well with the AREDS supplement formula (13%), was a particular genetic profile that resulted in AMD progression, notably because of the zinc in the formula. Genetic testing is a guide for those supplements that best helps reduce the risk for progression of the disease. Armed with this information, an eye doctor would recommend the patient not take the AREDS formula with zinc. This is personalized medicine. Giving everyone the AREDS vitamin supplement does not benefit everyone the same. Other genetic profiles do very well with the supplement.
While routine genetic testing is not the standard of care at this time, it is an option. Without genetic testing, doctors and patients do well by managing treatment and controlling health factors to decrease the progression of AMD. A t this time, both of these genetic tests may not be covered by insurance plans. and must be ordered through your eye care provider.