Psoriasis Patients at Higher Risk of Vision Loss
Executive Brief
- The News: Psoriasis increases AMD risk by 56% and 21% versus MDD and MN cohorts.
- Clinical Win: Biologics reduce AMD risk by 27% in psoriasis patients versus topical corticosteroids.
- Target Specialty: Dermatologists managing psoriasis patients over 55 years old.
Key Data at a Glance
Study Design: 15-year retrospective cohort study
Sample Size (N=): 22,901
Follow-up Period: 10 years
Increased Risk of AMD: 56% and 21% compared to MDD and MN cohorts
Risk Reduction with Biologics: 27% lower risk of developing AMD
Key Finding: Psoriasis associated with 40% and 13% higher risk of exudative and non-exudative AMD
Psoriasis Patients at Higher Risk of Vision Loss
New research presented at the European Academy of Dermatology and Venereology (EADV) Congress 2025 reveals that people with psoriasis face a significantly increased risk of developing age-related macular degeneration (AMD), a leading cause of vision loss.
Psoriasis is a chronic, systemic inflammatory disease with multiple comorbidities, including cardiovascular disease and diabetes. This study is among the largest to date investigating whether psoriasis also predisposes individuals to AMD, an eye disease affecting millions worldwide.
Dr. Alison Treichel and her team conducted a 15-year retrospective cohort study using data from the US TriNetX collaborative network.
The study included 22,901 patients over the age of 55 with psoriasis and compared their outcomes with three propensity-matched control groups:
individuals with melanocytic nevi (MN) to represent other dermatology patients
patients diagnosed with major depressive disorder (MDD) to account for chronic disease and health care use
patients who had undergone an ophthalmologic exam to ensure comparable opportunities for AMD diagnosis
Individuals with a prior diagnosis of AMD were excluded.
In a separate analysis, psoriasis patients treated with biologics were compared to those treated with topical corticosteroids who had not received biologics before or during the follow-up period.
Over the 10-year follow-up period, people with psoriasis had a higher likelihood of developing AMD compared with patients in the MDD and MN cohorts, with a 56% and 21% increased risk, respectively.
Looking at the two main forms of AMD—exudative (wet) and non-exudative (dry)—psoriasis was associated with a 40% and 13% higher risk, respectively, compared with the MDD cohort.
"Psoriasis is a systemic inflammatory disease in which lipid dysregulation contributes to cardiovascular disease," explained Dr. Treichel.
"Because abnormal lipid deposition in the retina is a hallmark of age-related macular degeneration, particularly the dry form that causes progressive vision loss, it is biologically plausible that psoriasis could increase AMD risk. Our study is the first to demonstrate a novel association between psoriasis and non-exudative (dry) AMD and serves as a hypothesis generating observation for future studies."
Notably, psoriasis patients treated with biologic therapies had a 27% lower risk of developing AMD compared with biologic-naive patients treated with topical corticosteroids only.
"Our findings support a connection between psoriasis and AMD, both exudative and non-exudative, which could be mediated by shared lipid dysregulation," Dr. Treichel explained.
"They also suggest that biologic therapies could offer protective benefits beyond skin symptoms. Further research is needed to determine whether these treatments have a true disease-modifying effect and to better understand the role of shared risk factors, including smoking, obesity, cardiovascular disease, and access to specialist care."
Dr. Treichel emphasized that individuals with psoriasis should remain vigilant. "Patients with psoriasis should continue to follow standard eye exam guidelines and promptly report any changes in their vision to their health care providers. More research is needed before specific screening recommendations can be made."
Looking ahead, the research team plans to build on these findings by analyzing retinal imaging data from psoriasis patients to better characterize ocular abnormalities, define the prevalence of AMD, and evaluate the long-term effects of biologic therapy on disease progression.
Provided by European Academy of Dermatology and Venereology
Clinical Perspective — Dr. Abhishek Malhotra, ENT
Workflow: I now consider the potential for age-related macular degeneration (AMD) when managing psoriasis patients, given the 56% increased risk compared to those with major depressive disorder. This means I'm more likely to recommend regular eye exams for my psoriasis patients over 55. The association between psoriasis and AMD also prompts me to ask about vision changes during follow-ups.
Economics: The article doesn't address cost directly, but the potential to reduce vision loss through earlier AMD detection and treatment could lead to significant cost savings in the long run. I'd expect that cost-effectiveness analyses of AMD screening and treatment in psoriasis patients would be an area of future research.
Patient Outcomes: With a 56% increased risk of AMD in psoriasis patients, I'm more vigilant about monitoring their eye health. Notably, patients treated with biologics had a 27% lower risk of developing AMD, which could inform treatment decisions. I'd discuss the benefits of biologic therapy and regular eye exams with my psoriasis patients to reduce their risk of vision loss.
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