Age related macular degeneration (AMD)

This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of age related macular degeneration

MF2402

Susan Boger & Mary L. Meck Higgins, Age-related macular degeneration (AMD), Kansas State University, August 1999

A Population-Based Ultra-Widefield Digital Image Grading Study for Age-Related Macular Degeneration-Like Lesions at the Peripheral Retina.

Our understanding of the relevance of peripheral retinal abnormalities to disease in general and in age-related macular degeneration (AMD) in particular is limited by the lack of detailed peripheral imaging studies. The purpose of this study was to develop image grading protocols suited to ultra-widefield imaging (UWFI) in an aged population

Targeted therapy in age-related macular degeneration (AMD)

Introduction and purpose: Age-related macular degeneration (AMD) is a major cause of blindness in highly developed countries, with blindness frequency of 8.7%. This article is a review of the latest therapeutic options for AMD.A brief description of the state of knowledge: AMD is a multifactorial disease which etiology is not completely understood. Its development is affected by disorders at the cellular level, environmental and genetic factors. Intraocular injections of anti-VEGF agents are currently considered as the basis of AMD neovascular treatment. In the search for better and better therapeutic agents, the effects of administration of bevacizumab and ranizumab were tested. Many clinical studies confirm long-term and effective improvement in patients' vision after using the above-mentioned drugs, indicating that the initial response to treatment and the persistence of the therapeutic effect is individually variable and may be associated with genotypic difference. Another promising alternative to AMD treatment is the use of specific viral vectors that transfer substances slowing down the disease into the vitreous. Another method of gene therapy is the use of HIF transcription factors (hypoxia-induced factors), for now, the research is performed on animal models. Patients with dry AMD also have a chance for successful treatment. Examined gene therapy in dry form of AMD, including retinal surgery combined with viral vector injection, is in I/II phase study in Great Britain.  Conclusions: Looking at the number of blindness cases in highly developed countries caused by AMD, every effort should be made to introduce effective treatment that at least inhibits disease progression. Undoubtedly, more research is needed to confirm the efficacy and long-term safety of AMD.

Matrix metalloproteinases in age-related macular degeneration (AMD)

Producción CientíficaAge-related macular degeneration (AMD) is a complex, multifactorial and progressive retinal disease affecting millions of people worldwide. In developed countries, it is the leading cause of vision loss and legal blindness among the elderly. Although the pathogenesis of AMD is still barely understood, recent studies have reported that disorders in the regulation of the extracellular matrix (ECM) play an important role in its etiopathogenesis. The dynamic metabolism of the ECM is closely regulated by matrix metalloproteinases (MMPs) and the tissue inhibitors of metalloproteinases (TIMPs). The present review focuses on the crucial processes that occur at the level of the Bruch’s membrane, with special emphasis on MMPs, TIMPs, and the polymorphisms associated with increased susceptibility to AMD development. A systematic literature search was performed, covering the years 1990–2020, using the following keywords: AMD, extracellular matrix, Bruch’s membrane, MMPs, TIMPs, and MMPs polymorphisms in AMD. In both early and advanced AMD, the pathological dynamic changes of ECM structural components are caused by the dysfunction of specific regulators and by the influence of other regulatory systems connected with both genetic and environmental factors. Better insight into the pathological role of MMP/TIMP complexes may lead to the development of new strategies for AMD treatment and prevention

Coping with Macular Degeneration: Three Case Studies

Educational Objectives 1. Learn about the diagnosis and available treatments for Age Related Macular Degeneration (AMD). 2. Explain the differences between Dry and Wet AMD. 3. Understand the impact of vision loss on the lives of older adults

Comparative Safety of Bevacizumab, Ranibizumab, and Aflibercept for Treatment of Neovascular Age-Related Macular Degeneration (AMD): A Systematic Review and Network Meta-Analysis of Direct Comparative Studies

Since the efficacy of ranibizumab (RBZ), bevacizumab (BVZ) and aflibercept (AFB) is comparable in neovascular age-related macular degeneration (AMD), we conducted a systematic review and meta-analysis to evaluate the long-term safety profiles of these agents, including ocular safety

Optimising dietary modification for age-related macular degeneration (AMD)

An ageing population has raised the priority of reducing the risk for age-related eye diseases that impair sight and quality of life. Chief among these diseases is age- related macular degeneration (AMD), the leading cause of visual impairment among older adults in the developed world. The dietary xanthophylls lutein and zeaxanthin may be effective at attenuating the risk and/or progression of AMD due to their antioxidant and photo-protective properties in the macula, where they are known as the macular pigment. The macular pigment is entirely of dietary origin therefore it is important that AMD patients adopt appropriate dietary modification. Currently, there is a lack of information regarding the lutein values of specific xanthophyll containing food sources. A lab based investigation was undertaken to determine the lutein concentrations in kale by high-performance liquid chromatography (HPLC); information was established that may improve knowledge on the climate and post-harvest handling, processing and storage effects. Lutein concentrations in minimally processed kale were significantly lower (p<0.001) than that of kale freshly harvested. Domestic cooking and storage also had substantial negative effects on kale lutein levels. A dietary analysis study and a qualitative based study were conducted to determine dietary habits in AMD patients. In align with previous work, AMD patients were found to be under consuming nutrients regarded as important for their condition. Subjects consumed an average of 1.7 mg of L and Z per day, and calorie intakes were significantly below government DRVs (p<0.05). Further investigations suggested that this may be attributed to certain physical and psychosocial barriers. Using the results of the laboratory based study, ready meals were created as a novel intervention to improve diet in this population. This body of research adds insights into dietary interventions within visually impaired groups, studies embedded may enrich dietary advice in the context of AMD

Optimising dietary modification for age-related macular degeneration (AMD)

An ageing population has raised the priority of reducing the risk for age-related eye diseases that impair sight and quality of life. Chief among these diseases is age- related macular degeneration (AMD), the leading cause of visual impairment among older adults in the developed world. The dietary xanthophylls lutein and zeaxanthin may be effective at attenuating the risk and/or progression of AMD due to their antioxidant and photo-protective properties in the macula, where they are known as the macular pigment. The macular pigment is entirely of dietary origin therefore it is important that AMD patients adopt appropriate dietary modification. Currently, there is a lack of information regarding the lutein values of specific xanthophyll containing food sources. A lab based investigation was undertaken to determine the lutein concentrations in kale by high-performance liquid chromatography (HPLC); information was established that may improve knowledge on the climate and post-harvest handling, processing and storage effects. Lutein concentrations in minimally processed kale were significantly lower (p<0.001) than that of kale freshly harvested. Domestic cooking and storage also had substantial negative effects on kale lutein levels. A dietary analysis study and a qualitative based study were conducted to determine dietary habits in AMD patients. In align with previous work, AMD patients were found to be under consuming nutrients regarded as important for their condition. Subjects consumed an average of 1.7 mg of L and Z per day, and calorie intakes were significantly below government DRVs (p<0.05). Further investigations suggested that this may be attributed to certain physical and psychosocial barriers. Using the results of the laboratory based study, ready meals were created as a novel intervention to improve diet in this population. This body of research adds insights into dietary interventions within visually impaired groups, studies embedded may enrich dietary advice in the context of AMD

Changes in Abdominal Obesity and Age-Related Macular Degeneration: The Atherosclerosis Risk in Communities Study

To examine the association between changes in waist-hip ratio (WHR), a measure of abdominal obesity, and age-related macular degeneration (AMD)