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Cited by 460Retinal Diseases and TreatmentsOcular Diseases and Behçet’s SyndromeRetinal Imaging and Analysis

Immunological and Aetiological Aspects of Macular Degeneration

Penfold, Philip L, Madigan, Michele C, Gillies, Mark C, Provis, Jan M·2001·Progress in Retinal and Eye Research
DOI 10.1016/s1350-9462(00)00025-2
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Abstract

Aetiological and immunological aspects of AMD, a leading cause of blindness in Western countries, have been reviewed. Developmental studies suggest that anatomical features unique to the fovea result in a critical relationship between metabolic demand and blood supply at the macula, which is maintained throughout life. Recent studies show a sufficient degree of consistency in the link between smoking and both dry and wet AMD to regard it as causative. Dry AMD is considered to be the natural endstage of the disease; epidemiological and morphological studies point to choroidal vascular atrophy as the causative event and it is suggested that signals associated with acute vascular compromise lead to the development of subretinal neovascularisation. The relationship between sub-pigment epithelial deposits, including basal laminar deposit, and the pathogenesis of AMD is examined. Much of the literature is consistent with a choroidal origin for the constituents of drusen. The blood-retinal barrier preserves the physiological environment of the neural retina and limits inflammatory responses. The factors, including cytokines, adhesion molecules and the presence of resident immunocompetent cells (microglia), which determine the immune status of the retina are considered. Historical descriptions of the involvement of inflammatory cells are provided, evidence implicating inflammation in the pathogenesis of AMD involving macrophages, giant cells and microglia has been derived from observations of human and animal subretinal neovascular lesions. The role of humoral factors such as anti-retinal autoantibodies and acute phase proteins together with clinical observations has been surveyed. Taken together these data demonstrate the involvement of both cellular and humoral immunity in the pathogenesis of AMD. It remains to be determined to what degree the influence of immunity is causative or contributory in both wet and dry AMD, however, the use of anti-inflammatory agents to ameliorate the condition further indicates the existence of an inflammatory component.

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Crossref · 10.1016/s1350-9462(00)00025-2

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  • Prevailing hypotheses regarding the origin of drusen are that drusen components are either derived from the retinal pigment epithelium or the choroidal vasculature.

    “Prevailing hypotheses regarding the origin of drusen are that drusen components are either derived from the RPE or the choroidal vasculature (9, 33).”

    From Drusen proteome analysis: an approach to the etiology of age-related macular degeneration (2002) · cites this paper as [33]

  • Macrophages have been documented both morphologically and functionally in neovascular age-related macular degeneration.

    “Macrophages have been documented both morphologically and functionally in neovascular age-related macular degeneration.137–142”

    From Age-related macular degeneration (2008) · cites this paper as [141]

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Authors
Penfold, P. L., Madigan, M. C., Gillies, M. C., & Provis, J. M.
Affiliations
The University of Sydney (AU)
Corresponding author
Penfold, Philip L
ORCID
Venue
Progress in Retinal and Eye Research
Publisher
Elsevier BV
Published
2001-05
Volume
20
Issue
3
Pages
385-414
ISSN
1350-9462 (ISSN-L)
DOI
10.1016/s1350-9462(00)00025-2
OpenAlex
W2092816889
Cited by
460
References
193
Citations by year
2026: 2 · 2025: 3 · 2024: 8 · 2023: 12 · 2022: 7 · 2021: 14 · 2020: 11 · 2019: 12 · 2018: 22 · 2017: 16 · 2016: 14 · 2015: 27 · 2014: 24 · 2013: 27 · 2012: 22
FWCI
4.89
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Progress in Retinal and Eye Research (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
Keywords
age-related macular degeneration, dry age-related macular degeneration, neovascular age-related macular degeneration, drusen, basal laminar deposits, blood-retinal barrier, retinal inflammation, microglia, macrophages, acute phase proteins, smoking, fovea, immune pathogenesis
MeSH terms
Animals, Humans, Immunity, Macula Lutea, Macular Degeneration

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