Measurement of drusen and their correlation with visual symptoms in patients affected by age-related macular degeneration

Pinelli, Roberto; Bertelli, Matteo; Scaffidi, Elena; Fulceri, Federica; Busceti, Carla Letizia; Biagioni, Francesca; Fornai, Francesco

doi:10.12871/000398292020343

Cited by 11 publications

(28 citation statements)

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“…The dry variant is slower, though invariably leads to deterioration and ultimately blindness. In fact, at clinical level the disease manifests with a loss of visual acuity and contrast sensitivity, which are provided by a selective impairment of macular vision [51,90,92,93]. A typical symptom often described in AMD consists of distorted, wavy lines along the horizontal and vertical axis known as metamorphopsia [93].…”

Section: Dysfunctional Autophagy In the Inner Choroid/outer Retina Is...mentioning

confidence: 99%

“…In fact, at clinical level the disease manifests with a loss of visual acuity and contrast sensitivity, which are provided by a selective impairment of macular vision [51,90,92,93]. A typical symptom often described in AMD consists of distorted, wavy lines along the horizontal and vertical axis known as metamorphopsia [93]. The mechanisms which produce a loss of visual acuity are considered to rely on the loss of retinal planarity and a loss of foveal cones, which also suppresses contrast sensitivity.…”

Section: Dysfunctional Autophagy In the Inner Choroid/outer Retina Is...mentioning

confidence: 99%

“…According to the classic perspective, within the retina, this volume effect is commonly expected to alter the planar arrangement of the photoreceptors. This was commonly considered to produce visual distortion, such as metamorphopsia, which is quite typical in AMD [17,93]. In this way, visual loss was thought to be a secondary event solely generated by the loss of retinal planarity.…”

Section: An Autophagy Defect Within Rpe May Early Induce a Visual Def...mentioning

confidence: 99%

“…If this is correct, one should expect that the measurement of the drusenoid area, calculated in the retina in the course of AMD, should predict the amount of loss in visual acuity and the occurrence of visual distortions. However, when the drusenoid area is calculated in AMD patients, a dissociation emerges between the amount of the drusenoid area and the severity of visual symptoms ( [93] and representative data in Table 1). These findings lead to the hypothesis that an autophagy defect impairs visual function more as a result of a fine molecular deficit impairing the molecular mechanisms of visions, rather than a gross mechanical alteration of retinal planarity due to sub-retinal aggregates.…”

Section: An Autophagy Defect Within Rpe May Early Induce a Visual Def...mentioning

confidence: 99%

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The Essential Role of Light-Induced Autophagy in the Inner Choroid/Outer Retinal Neurovascular Unit in Baseline Conditions and Degeneration

Pinelli

Ferrucci

Berti

et al. 2023

IJMS

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The present article discusses the role of light in altering autophagy, both within the outer retina (retinal pigment epithelium, RPE, and the outer segment of photoreceptors) and the inner choroid (Bruch’s membrane, BM, endothelial cells and the pericytes of choriocapillaris, CC). Here autophagy is needed to maintain the high metabolic requirements and to provide the specific physiological activity sub-serving the process of vision. Activation or inhibition of autophagy within RPE strongly depends on light exposure and it is concomitant with activation or inhibition of the outer segment of the photoreceptors. This also recruits CC, which provides blood flow and metabolic substrates. Thus, the inner choroid and outer retina are mutually dependent and their activity is orchestrated by light exposure in order to cope with metabolic demand. This is tuned by the autophagy status, which works as a sort of pivot in the cross-talk within the inner choroid/outer retina neurovascular unit. In degenerative conditions, and mostly during age-related macular degeneration (AMD), autophagy dysfunction occurs in this area to induce cell loss and extracellular aggregates. Therefore, a detailed analysis of the autophagy status encompassing CC, RPE and interposed BM is key to understanding the fine anatomy and altered biochemistry which underlie the onset and progression of AMD.

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Section: Dysfunctional Autophagy In the Inner Choroid/outer Retina Is...mentioning

confidence: 99%

Section: Dysfunctional Autophagy In the Inner Choroid/outer Retina Is...mentioning

confidence: 99%

Section: An Autophagy Defect Within Rpe May Early Induce a Visual Def...mentioning

confidence: 99%

Section: An Autophagy Defect Within Rpe May Early Induce a Visual Def...mentioning

confidence: 99%

See 2 more Smart Citations

The Essential Role of Light-Induced Autophagy in the Inner Choroid/Outer Retinal Neurovascular Unit in Baseline Conditions and Degeneration

Pinelli

Ferrucci

Berti

et al. 2023

IJMS

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“…In fact, stem cell in the CNS are strongly stimulated to proliferate and differentiate towards a neuronal phenotype following autophagy activation (Chang et al, 2020). In recent reports we provided evidence showing that autophagy activation may sort protective effects and promote anatomical and functional recovery in the retina affected by chronic degeneration (Pinelli et al, 2020b(Pinelli et al, , 2020c2020d;2021a;2021b). In fact, the autophagy status of a number of retinal cells is key in promoting the integrity of the retina.…”

Section: Introductionmentioning

confidence: 99%

Combined pulses of light and sound in the retina with nutraceuticals may enhance the recovery of foveal holes

Pinelli¹,

Berti²,

Scaffidi³

et al. 2022

Archives Italiennes De Biologie

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The present manuscript stems from evidence, which indicates that specific wavelength produce an activation of the autophagy pathway in the retina. These effects were recently reported to synergize with the autophagy-inducing properties of specific phytochemicals. The combined administration of photo-modulation and phytochemicals was recently shown to have a strong potential in eliciting the recovery in the course of retinal degeneration and it was suggested as a non-invasive approach named "Lugano protocol" to treat age-related macular degeneration (AMD). Recent translational findings indicate that the protective role of autophagy may extend also to acute neuronal injuries including traumatic neuronal damage. At the same time, very recent investigations indicate that autophagy activation and retinal anatomical recovery may benefit from sound exposure. Therefore, in the present study, the anatomical rescue of a traumatic neuronal loss at macular level was investigated in a patient with idiopathic macular hole by using a combined approach of physical and chemical non-invasive treatments. In detail, light exposure was administered in combination with sound pulses to the affected retina. This treatment was supplemented by phytochemicals known to act as autophagy inducers, which were administered orally for 6 months. This combined administration of light and sound with nutraceuticals reported here as Advanced Lugano's Protocol (ALP) produced a remarkable effect in the anatomical architecture of the retina affected by the macular hole. The anatomical recovery was almost complete at roughly one year after diagnosis and beginning of treatment. The structural healing of the macular hole was concomitant with a strong improvement of visual acuity and the disappearance of metamorphopsia. The present findings are discussed in the light of a synergism shown at neuronal level between light and sound in the presence of phytochemicals to stimulate autophagy and promote proliferation and neuronal differentiation of retinal stem cells.

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Investigational drugs in clinical trials for macular degeneration

Tolentino

2022

Expert Opinion on Investigational Drugs

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Measurement of drusen and their correlation with visual symptoms in patients affected by age-related macular degeneration

Cited by 11 publications

References 0 publications

The Essential Role of Light-Induced Autophagy in the Inner Choroid/Outer Retinal Neurovascular Unit in Baseline Conditions and Degeneration

The Essential Role of Light-Induced Autophagy in the Inner Choroid/Outer Retinal Neurovascular Unit in Baseline Conditions and Degeneration

Combined pulses of light and sound in the retina with nutraceuticals may enhance the recovery of foveal holes

Investigational drugs in clinical trials for macular degeneration

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