Case #79: Type 3 Macular Neovascularization: a Unique Form of ARMD with a Possible Link to Stress – Page 13 of 16

Association Between ARMD and Stress

Lavine et al. (2013) demonstrated that the β-adrenergic signaling pathway, which is activated during psychological stress, plays a direct role in promoting CNV. Using a mouse model of laser-induced CNV, they concluded that treatment with the beta blocker propranolol reduced CNV by 50%. Conversely, up-regulating the β-adrenergic pathway using norepinephrine stimulated VEGF release in choroidal and RPE cells. This suggests that psychological stress, which triggers the sympathetic nervous system to release norepinephrine, could continuously promote VEGF overproduction. This suggests that stress could be a potentially modifiable risk factor in the development and progression of AMD.⁸

Further studies are needed to determine if psychological stress directly causes dry AMD to covert to wet AMD.