Serum TNFα Levels May Serve as Biomarker for High-Risk Intermediate AMD

Age-related macular degeneration (AMD). Fundoscopy image of the retina of a patient’s eye in a case of age-related macular degeneration. The retina is the light-sensitive layer at the back of the eye. The macula is the area of the retina responsible for central vision, which is the sharpest. It is not known what causes macular degeneration, although old age, poor nutrition and overexposure to the ultraviolet radiation in sunlight have all been implicated. The main symptom is a loss of central vision, meaning reading and delicate tasks become difficult or impossible. Some distortion of peripheral vision may also occur. There is no effective treatment for this kind of degeneration.
Intermediate AMD is associated with higher serum levels of TNF, a key regulator of the inflammatory response, compared with controls, according to presenters at the ASRS 2022.

Serum TNFα levels appear to increase in patients with intermediate age-related macular degeneration (AMD) and may serve as a potential biomarker to identify patients with high-risk disease, according to research presented at the American Society of Retina Specialists 40th annual meeting, held in New York, July 13-16, 2022.

The researchers hypothesized that systemic inflammatory markers can be used to distinguish patients with and without intermediate AMD. To test this hypothesis, they compared levels of plasma cytokines (TNFα, IL-6, IL-8, IL-1ra, IL-4, and VEGF) in patients with intermediate AMD with those of patients with no AMD (controls).

A total of 311 patients were included in the study, 211 patients with intermediate AMD and 100 control participants. The groups were well balanced for smoking status, body mass index, hypertension, and cardiac and vascular disease. 

The researchers report that TNFα levels were significantly higher in the patients with intermediate AMD compared with the control participants (7.5 vs 6.5 pg/mL; P <.01). They observed no significant difference between the groups in the levels of IL-6, IL-8, IL-1ra, IL-4, or VEGF.

“TNFα is produced by macrophages, monocytes and other cells and has been shown to have direct effects on retinal pigment epithelial cells including induction of complement expression and up-regulation of VEGF production,” according to the presenters. “These findings support our hypothesis that systemic inflammatory markers can distinguish patients with and without [intermediate AMD]. Serum TNFa levels can potentially be used as a biomarker to identify high risk patients with [intermediate AMD].”


Ghiassi M, Wagner BD, Palestine AG, Mandava N, Lynch AM. TNFα and other select cytokines in patients with intermediate age-related macular degeneration (iAMD). Poster presented at: The 40th annual meeting of the American Society of Retina Specialists; June 13-16, 2022; New York. Poster 109.