From the skin to the eye, there is sometimes only one step, or almost. The proof is in a study presented at the last European Congress of Dermatology (European association of dermatology and venerology) which is currently taking place in Paris. It confirms that people with psoriasis, a chronic autoimmune inflammatory disease triggered by a combination of genetic and environmental factors, have a significantly increased risk of developing age-related macular degeneration (AMD), a major cause of blindness.
"It is biologically plausible that psoriasis may increase the risk of AMD."
This is actually not the first time this link has been mentioned, the first works on this association dating back more than 10 years and a extensive study presented in 2024 and carried out on more than 2 million type 2 diabetic patients had also demonstrated that psoriasis could be considered an independent risk factor for the development of one of the forms of AMD, the so-called exudative form.
In this new work, the American team from the University of Rochester analyzed data from more than 20,000 psoriasis patients aged over 55, followed them over a period of 15 years and looked at the fine mechanisms linking the two diseases, focusing here rather on the risk of developing the so-called dry form of AMD.
“ Psoriasis is a systemic inflammatory disease in which lipid dysregulation contributes to cardiovascular disease., explains Dr. Alison Treichel, a dermatologist at the University of Rochester who led this work. Since abnormal lipid deposition in the retina is a feature of age-related macular degeneration, particularly the dry form that leads to progressive vision loss, it is biologically plausible that psoriasis may increase the risk of AMD., she commented.
Preliminary work which, at this stage, can only result in the recommendation of regular ophthalmological monitoring, as proposed by Dr. Treichel, by educating people with psoriasis to quickly report any changes in their vision.
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Psoriasis, a condition that remains very mysterious
Further research will continue by analyzing retinal imaging data from patients to better characterize ocular abnormalities, define the prevalence of AMD in this population and assess the long-term effects of biological treatments on disease progression.
Because, Good news, more concrete and highlighted by this work: patients treated with biotherapies, these treatments which appeared more than 10 years ago and have revolutionized the management of the disease and act on the different agents of inflammation (TNF alpha, anti-interleukin 17, 22, 23, etc.), have a reduced risk (- 27%) of developing AMD compared to those treated only with locally applied corticosteroids.
The fact remains that to date, patients who benefit from these approaches, those with the most severe and widespread forms, do not always have access to these treatments, as pointed out in 2021 the France Psoriasis association, most often due to difficulties in obtaining an appointment with a practitioner.
As a reminder, in the face of this disease, which affects approximately 2% of the French population and 30% of cases have a familial origin, symptoms other than skin-related may be present. For example, joint symptoms (articular rheumatism) in 20% of cases, or others, cardiological or even digestive. From the skin to the eye, including the bone, the heart and even the intestine, so many mechanisms remain to be deciphered in the face of a affection still very mysterious.
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