New Research Offers Insights into Slowing Age-Related Macular Degeneration

A recent study conducted by researchers at Washington University School of Medicine in St. Louis has identified a potential method to slow or halt the progression of age-related macular degeneration (AMD), a leading cause of vision loss in individuals over the age of 50. Published in the journal Nature Communications on June 24, 2025, this groundbreaking research provides new insights into the relationship between cholesterol metabolism and AMD, suggesting that increasing levels of a molecule known as apolipoprotein M (ApoM) may offer therapeutic benefits.

Age-related macular degeneration affects millions worldwide and is characterized by the gradual deterioration of the macula, the part of the retina responsible for sharp central vision. This condition typically progresses through two main forms: "dry" AMD, which involves the atrophy of retinal cells, and "wet" AMD, marked by abnormal blood vessel growth that can severely damage vision. Current treatment options are limited and primarily focus on advanced stages of the disease, with no existing therapies capable of reversing its effects.

According to Dr. Rajendra S. Apte, MD, PhD, the senior author of the study and the Paul A. Cibis Distinguished Professor of Ophthalmology and Visual Sciences at WashU Medicine, "Our study points to a possible way to address a major unmet clinical need. Current therapies that reduce the chance of further vision loss are limited to only the most advanced stages of macular degeneration and do not reverse the disease. Our findings suggest that developing treatments that increase ApoM levels could treat or even prevent the disease and therefore preserve people's vision as they age."

The researchers discovered that lower levels of ApoM are present in the blood of patients with AMD compared to healthy individuals. This finding aligns with previous studies indicating that ApoM plays a protective role in cholesterol metabolism and possesses anti-inflammatory properties. Dr. Ali Javaheri, MD, PhD, a co-senior author and assistant professor of medicine at WashU Medicine, emphasized the significance of these findings, stating, "It is possible that the interaction between ApoM and sphingosine-1-phosphate is regulating cholesterol metabolism in both cell types. We look forward to exploring strategies to increase ApoM in ways that could help the eye and the heart maintain healthy cholesterol metabolism over time and stave off two major diseases of aging."

Using human plasma samples and mouse models, the researchers demonstrated that increasing ApoM levels led to improved retinal health and reduced cholesterol accumulation in mouse models of AMD. The study highlights the possibility of utilizing genetic modification or plasma transfer techniques to elevate ApoM levels, which in turn may enhance the clearance of excess cholesterol from the retina and heart.

The implications of this research extend beyond AMD, as the mechanisms underlying cholesterol metabolism are also relevant to cardiovascular health. The study suggests that interventions aimed at boosting ApoM could potentially prevent or mitigate heart failure, a condition that shares similar risk factors with AMD.

In conclusion, the findings from Washington University School of Medicine pave the way for innovative treatment strategies that could revolutionize care for both age-related macular degeneration and heart disease. Continued research in this area may lead to clinical applications that enhance the quality of life for millions of aging individuals facing these debilitating conditions. As the population ages, the need for effective strategies to combat age-related diseases becomes increasingly critical, underscoring the importance of this groundbreaking study.