Kananen F, Strandberg T, Loukovaara S, et al. - This study was undertaken to determine if serum cholesterol in early middle age is correlated with age‐related macular degeneration (AMD) later in life. A group of Helsinki Businessmen Study (HBS) candidates (n = 209) were selected for the study. During the HBS baseline visit in 1964–1973, total cholesterol (TC), triglyceride and BMI were measured. In individuals later developing intermediate or late AMD or with drusen size of ≥ 125 µm compared with the rest of the study population, TC measured at baseline 1964–1973 was significantly higher. In early middle age, high systemic total cholesterol can play a role in the initial development of AMD, particularly in patients who later develop large drusen.