Figure 4.

Siblings extremely discordant for AMD. These fundus images illustrate the retinas of discordant siblings with identical risk profiles for major AMD genetic loci, smoking, BMI, and CVD. Note the severe neovascular AMD in one sibling and normal macula in the other at a comparable age. Environmentally induced epigenetic changes may explain the occurrence of such discordance for AMD or other age-related disease. OD, oculus dexter (right eye); OS, oculus sinister (left eye). Photographs taken from DeAngelis laboratory patient cohorts. The study protocol was reviewed and approved by the Institutional Review Board at the University of Utah and conforms to the tenets of the Declaration of Helsinki.