The Dry Form of Age-Related Macular Degeneration (AMD): The Current Concepts of Pathogenesis and Prospects for Treatment

Abstract

Age-related macular degeneration (AMD) is a disease that causes varying degrees of blindness, which afflicts millions of adults in their later years. Preliminary changes occur during normal aging, but in some individuals the pathology leads to the development of AMD. The pathology seems to be a mixture of biochemical, cellular, and molecular events. Lipofuscinogenesis and early drusen genesis are in the early stages of AMD and their inhibition or reversal would dramatically increase the quality of vision in elderly people. The disease is characterized by abnormal extracellular deposits, known as drusen, which accumulate along the basal surface of the retinal pigmented epithelium RPE. Widespread drusen deposition is associated with retinal pigmented epithelial cell dysfunction and degeneration of the photoreceptors. Recent studies have shown that drusen contain a variety of immunomodulatory molecules, suggesting that the process of drusen formation involves local inflammatory events, including activation of the complement cascade. Molecular pathways involved in the etiology of this disease and the potential prospects of its treatment will be presented on the basis of the results of the current studies.

Epidemiological profile of age-related macular degeneration patients in Federal University of Parana, Brazil

“…The solar exposure, presumably due to ultraviolet rays, may interfere in AMD development. A similar prevalence of European inhabitants could be inferred for the Brazil's south region and (around 8 to 27%) and similar to central America in north region (4,9,(23)(24)(25)(26)(27) . A mean age of 73 years for AMD patients was found.…”

Associations of Alzheimer rsquo s disease with macular degeneration

“…It has been supposed that the impairment of the function of mtDNA-encoded subunits of the electron transport chain may evoke increased superoxide anion production; it causes further mtDNA damage and superoxide anion production (8). Interestingly, autophagy and lysosomal processes linked to oxidative stress are increased in AMD eyes (5) and AD brain (89). Moreover, an oxysterol, 27-Hydroxycholesterol, appears to be implicated in oxidative damage both in AMD and AD.…”

Fundus autofluorescence and multicolour imaging comparison in assessing disease severity in patients suffering from geographic atrophy. A case series analysis

“…Funduscopically [11], in early to intermediate dry AMD there is significant presence of multiple drusen. In intermediate dry AMD, drusen may appear confluent with significant pigment changes and pigment accumulation in the posterior pole.…”

“…Dry macular degeneration symptoms usually develop gradually [11]. They may include: visual distortions, such as straight lines seeming bent, reduced central vision in one or both eyes, increased blurriness of printed words, the need for brighter light when reading or doing close work, increased difficulty adapting to low light levels, decreased intensity or brightness of colours, and difficulty recognising faces.…”