Cited by 203Retinal Diseases and TreatmentsRetinal Imaging and AnalysisRetinal and Macular Surgery

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Pathogenesis of lesions in late age-related macular disease

Holz, Frank G., Pauleikhoff, Daniel, Klein, Ronald, Bird, Alan C.·2004·American Journal of Ophthalmology

DOI 10.1016/j.ajo.2003.11.026

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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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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.
ORCID: Holz, Frank G.
Pauleikhoff, Daniel
Klein, Ronald
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)
DOI: 10.1016/j.ajo.2003.11.026
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
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
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 › Ophthalmology › 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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