Age-related macular degeneration: Etiology, pathogenesis, and therapeutic strategies

Jayakrishna Ambati, Balamurali K. Ambati, Sonia H. Yoo, Sean Ianchulev, Anthony P. Adamis

Research output: Contribution to journalReview article

740 Scopus citations

Abstract

Age-related macular degeneration is the principal cause of registered legal blindness among those aged over 65 in the United States, western Europe, Australia, and Japan. Despite intensive research, the precise etiology of molecular events that underlie age-related macular degeneration is poorly understood. However, investigations on parallel fronts are addressing this prevalent public health problem. Sophisticated biochemical and biophysical techniques have refined our understanding of the pathobiology of drusen, geographic atrophy, and retinal pigment epithelial detachments. Epidemiological identification of risk factors has facilitated an intelligent search for underlying mechanisms and fueled clinical investigation of behavior modification. Gene searches have not only brought us to the cusp of identifying the culpable gene loci in age-related macular degeneration, but also localized genes responsible for other macular dystrophies. Recent and ongoing investigations, often cued by tumor biology, have revealed an important role for various growth factors, particularly in the neovascular form of the condition. Transgenic and knockout studies have provided important mechanistic insights into the development of choroidal neovascularization, the principal cause of vision loss in age-related macular degeneration. This in turn has culminated in preclinical and clinical trials of directed molecular interventions.

Original languageEnglish (US)
Pages (from-to)257-293
Number of pages37
JournalSurvey of Ophthalmology
Volume48
Issue number3
DOIs
StatePublished - Jan 1 2003

Keywords

  • Age-related macular degeneration
  • Choroidal neovascularization
  • Drusen
  • Macular dystrophies

ASJC Scopus subject areas

  • Ophthalmology

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