Growing evidence suggests a potential link between psoriasis and dry age-related macular degeneration (AMD), possibly mediated by shared lipid dysregulation.¹ In psoriasis, altered lipid metabolism contributes to atherosclerosis and cardiovascular diseases, while in dry AMD, abnormal lipid accumulation in the retina leads to drusen formation.¹ Although earlier studies have associated psoriasis with the wet (exudative) form of AMD, its association with the dry (non-exudative) form remains less well-understood.¹ At the 2025 EADV Congress, Dr. Alison Treichel from the University of Rochester in the United States (US) presented results from a large retrospective cohort study comparing the incidence of unspecified, dry, and wet AMD in psoriasis patients aged ≥55 years, and evaluated the outcomes between those treated with biologics and those treated with topical corticosteroids over a 10-year period.¹

The 15-year retrospective cohort study (2009-2024) was conducted using data from the US TriNetX collaborative research network.¹ A total of 22,901 patients aged ≥55 years with psoriasis who had undergone at least one ocular examination during a 10-year observation period were identified, excluding those with a prior diagnosis of AMD.¹ To ensure comprehensive comparisons, three matched control cohorts were established: individuals with melanocytic nevus (MN) to represent other dermatology patients, patients with major depressive disorder (MDD) to account for chronic disease and healthcare use, and those who had undergone an ocular examination (OE) to ensure comparable opportunities for AMD diagnosis.¹ The analysis evaluated the 10-year incidence of unspecified, dry (non-exudative), and wet (exudative) AMD across the groups.¹ Additionally, the associations of systemic biologic therapy vs. topical corticosteroid use on AMD risk among psoriasis patients were also examined.¹

The study population was predominantly female and Caucasians, with a mean age of over 60 years.¹ The analysis found that psoriasis was associated with an increased risk of unspecified, wet, and dry AMD.¹ For instance, over the 10-year follow-up, patients with psoriasis demonstrated a 56% higher risk of unspecified AMD compared with those with MDD (p<0.0001).¹ Psoriasis was also associated with a 40% increased risk of wet AMD (p=0.0022) and a 13% higher risk of dry AMD (p=0.0307) relative to the MDD cohort.¹ Similarly, compared with controls with MN, psoriasis patients had a 20% increased risk of unspecified AMD (p=0.0097).¹

Treatment exposure appeared to influence outcomes.¹ Psoriasis patients treated with biologic therapy had a 27% lower risk of developing AMD over 10 years compared with biologic-naïve patients receiving topical corticosteroids (HR=0.73; 95% CI: 0.61-0.88).¹ This finding suggests that biologic therapies may confer a protective effect, potentially by improving lipid regulation and reducing oxidative stress.¹

In conclusion, psoriasis was linked to both dry and wet AMD, which may be attributed to shared lipid dysregulation.¹ The results highlight the importance of vigilance for ocular comorbidities in psoriasis management.¹ Routine screening may facilitate earlier detection and intervention for AMD in this patient population.¹ Further research is warranted to better characterize ocular manifestations in psoriasis and to clarify the long-term impact of biologic therapy on AMD progression.¹