Age-related macular degeneration: clinical findings, histopathology and imaging techniques

Marco A. Zarbin, Ricardo P. Casaroli-Marano, Philip J Rosenfeld

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Age-related macular degeneration (AMD) is the most common cause of blindness among people over age 55 years in industrialized countries. Known major risk factors for AMD include: age >55 years, history of smoking, white race, and mutations in various components of the complement system. Early AMD is characterized by the presence of drusen and pigmentary abnormalities. Late AMD is associated with central visual loss and is characterized by the presence of choroidal neovascularization and/or geographic atrophy. Early AMD is associated with a number of biochemical abnormalities including oxidative damage to retinal pigment epithelium (RPE) cells, complement deposition in the RPE-Bruch's membrane-choriocapillaris complex, lipidization of Bruch's membrane, and extracellular matrix abnormalities (e.g. collagen crosslinking, advanced glycation end product formation). Antiangiogenic drugs block the vascular leakage associated with choroidal new vessels, thus reducing retinal edema and stabilizing or restoring vision. At this time, there are no proven effective treatments for the nonexudative complications of AMD. Modern ocular imaging technologies (including spectral domain and phase variance optical coherence tomography, short- and long-wavelength fundus autofluorescence, adaptive optics-scanning laser ophthalmoscopy, and near-infrared reflectance) enable one to follow changes in the RPE, photoreceptors, and choriocapillaris quantitatively as the disease progresses. In addition, one can quantitatively assess the volume of drusen and areas of atrophy. These data, when correlated with the known histopathology of AMD, may provide useful measures of treatment efficacy that are likely to be more sensitive and reproducible than conventional end points such as visual acuity and rate of enlargement of geographic atrophy. As a result, these imaging technologies may be valuable in assessing the effects of cell-based therapy for patients with AMD.

Original languageEnglish
Pages (from-to)1-32
Number of pages32
JournalDevelopments in Ophthalmology
Volume53
DOIs
StatePublished - Jan 1 2014

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Macular Degeneration
Retinal Pigment Epithelium
Geographic Atrophy
Bruch Membrane
Technology
Ophthalmoscopy
Choroidal Neovascularization
Papilledema
Advanced Glycosylation End Products
Optical Coherence Tomography
Blindness
Cell- and Tissue-Based Therapy
Developed Countries
Visual Acuity
Atrophy
Extracellular Matrix
Blood Vessels
Lasers
Collagen
Smoking

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Age-related macular degeneration : clinical findings, histopathology and imaging techniques. / Zarbin, Marco A.; Casaroli-Marano, Ricardo P.; Rosenfeld, Philip J.

In: Developments in Ophthalmology, Vol. 53, 01.01.2014, p. 1-32.

Research output: Contribution to journalArticle

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