Metabolomic Profiling of the Aqueous Humor in Patients with Wet Age-Related Macular Degeneration using UHPLC-MS/MS.

Assessing metabolomic alterations in age-related macular degeneration (AMD) can provide insight on its pathogenesis. We compared the metabolomic profiles of the aqueous humor between wet AMD patients (n=26) and age- and sex-matched patients undergoing cataract surgery without AMD as controls (n=20). A global untargeted metabolomics study was performed using ultra-high-performance liquid chromatography tandem-mass spectrometry. Univariate analysis after the false discovery correction showed 18 significantly altered metabolites among the 291 metabolites measured. These differential metabolomic profiles pointed to 3 interconnected metabolic pathways: a compromised carnitine-associated mitochondrial oxidation pathway (carnitine, deoxycarnitine, N6-trimethyl-L-lysine), an altered carbohydrate metabolism pathway (cis-aconitic acid, itaconatic acid, and mesaconic acid) which plays a role in senescence and immunity, and an activated osmoprotection pathway (glycine betaine, creatine), which potentially contributes to the pathogenesis of the disease. These results suggested that metabolic dysfunction in AMD is mitochondrial-centered, and may provide new insight on the pathophysiology of wet AMD and novel therapeutic strategies.