I read with considerable interest the article "Dietary Fat and Age-Related Maculopathy" by Mares-Perlman et al in the June 1995 issue of the Archives.1 I agree with their conclusion that their results support the hypothesis that the risk factors for atherosclerosis are related to age-related maculopathy. I would like to suggest, however, that the relationship should be between the risk factors for arteriosclerosis and age-related maculopathy, rather than atherosclerosis.
This suggestion is based on a recently published model of pathogenesis of age-related macular degeneration(Figure).2 This model proposes that this disorder is the end result of a process involving the aging sclera that is initiated by lipoidal infiltration and resembles arteriosclerosis. The risk factors for arteriosclerosis and atherosclerosis are similar if not identical;
Friedman E. Dietary Fat and Age-Related Maculopathy. Arch Ophthalmol. 1996;114(2):235-236. doi:10.1001/archopht.1996.01100130229031