Pathogenesis of lesions in late age-related macular disease
Abstract
Purpose To review the evidence that exists concerning the pathogenesis of lesions in late age-related macular disease (AMD).Design Review of the literature.Methods A review of both experimental evidence and clinical observations that address these problems.Results There is good evidence that choroidal neovascularization (CNV) is due to a change in the balance of growth factors derived from the retinal pigment epithelial basolateral plasma membrane domain (retinal pigment epithelium). Retinal angiomatous proliferation may also have a similar pathogenesis involving the apical domain. Detachment of the retinal pigment epithelium is likely to be a consequence of increased resistance of the Bruch membrane to water flow due to deposition of lipids. Geographic atrophy is preceded by accumulation of autofluorescent material in the retinal pigment epithelium and possible causal relationships between the two have been demonstrated.Conclusion There is increasing understanding concerning the sequence of events that lead to those lesions causing loss of central vision in AMD. Therapeutic approaches that address the underlying mechanisms are more likely to succeed than current treatment options. Such an approach has already been initiated in the management of choroidal neovascularization.
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The pathogenesis of age-related macular degeneration is not well known, although theories include oxidative stress, mitochondrial dysfunction, and inflammatory processes.
“The pathogenesis of age-related macular degeneration is not well known, although a number of theories have been put forward, including oxidative stress, mitochondrial dysfunction, and inflammatory processes.9–13”
From Age-related macular degeneration (2008) · cites this paper as [12]
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- Authors
- Holz, F. G., Pauleikhoff, D., Klein, R., & Bird, A. C.
- Affiliations
- Heidelberg University (DE)
- St. Franziskus Hospital (DE)
- University of Wisconsin–Madison (US)
- University of London (GB)
- Corresponding author
- Bird, Alan C.
- Venue
- American Journal of Ophthalmology
- Publisher
- Elsevier BV
- Published
- 2004-03
- Volume
- 137
- Issue
- 3
- Pages
- 504-510
- ISSN
- 0002-9394 (ISSN-L)
- OpenAlex
- W2168896662
- Cited by
- 203
- References
- 53
- Citations by year
- 2025: 2 · 2024: 7 · 2023: 5 · 2022: 3 · 2021: 7 · 2020: 7 · 2019: 6 · 2018: 10 · 2017: 10 · 2016: 8 · 2015: 4 · 2014: 9 · 2013: 11 · 2012: 13
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Ophthalmology (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal and Macular Surgery
- Keywords
- age-related macular degeneration, choroidal neovascularization, retinal pigment epithelium, retinal angiomatous proliferation, pigment epithelial detachment, Bruch's membrane, geographic atrophy, lipofuscin accumulation, growth factors, pathogenesis
- MeSH terms
- Humans, Macular Degeneration, Vision Disorders
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