ARVO 2026: Diet and its affect on AMD progression

Dimitra Skondra, MD, PhD, professor and vice chair of Ophthalmology at NYU Langone Health, spoke at ARVO 2026 in Denver, Colorado on the evolving understanding of age-related macular degeneration (AMD), emphasizing the role of diet and the gut–retina axis in both disease risk and progression.

She explained that the traditional AMD paradigm—centered largely on ocular biology alone—is shifting toward a more integrated model that includes systemic factors and lifestyle, particularly nutrition. Over the last decade, a growing body of work has demonstrated that diet influences not only the risk of developing AMD but also the likelihood of disease progression and vision loss. Central to this emerging perspective is the gut microbiome, which appears to mediate the impact of dietary patterns on retinal health.

Skondra reviewed findings from multiple research groups examining high-fat and high-sugar diets, as well as her team’s work on more “real-world” dietary patterns characterized by increased saturated fats and refined sugars. Across these studies, there is a consistent signal that changes in microbial diversity and composition are linked to AMD-related features. Her group has used sophisticated experimental models to test whether these microbiome shifts are merely epiphenomena or true drivers of disease. Their data support a causal role for the gut microbiome in mediating diet-induced AMD changes.

Importantly, Skondra highlighted that protective dietary patterns, such as a Mediterranean-style diet, also appear to exert their beneficial effects through the microbiome. Beyond which microbes are present, microbial function matters: her team has identified small, gut-derived metabolites that correlate with AMD progression, risk, and severity in both animal models and patients.

Skondra stressed the clinical and translational potential of this work. The gut microbiome is dynamic and modifiable, offering opportunities for dietary interventions and, in future, microbiome-targeted therapies to slow or halt AMD progression. She underscored the need for ophthalmologists to discuss diet more proactively with patients, provide educational resources, and collaborate with nutrition professionals. She also called for better nutrition education in medical training and anticipates that these pathways will ultimately inform novel therapeutics for AMD, reframing the disease as one influenced by systemic health, gut ecology, and lifestyle—not just local ocular pathology.