干性年龄相关性黄斑变性动物模型研究进展

年龄相关性黄斑变性(AMD)是55岁以上人群主要的致盲眼病之一.随着中国老龄化问题的日益严重,其患病率逐年升高,其治疗也成为研究的热点,其中干性AMD的发病机制尚不明确,故缺乏有效的治疗措施.以往已有大量的基础研究关注干性AMD发病的分子机制,然而,缺乏合适的动物模型成为研究过程中的一大困扰.目前,研究已发现多种干性AMD动物模型,为相关研究工作提供了重要工具,但是不同的动物模型有其优缺点,病变发生的过程也不尽相同,在研究中选择合适的模型对相关研究至关重要.就近年来国内外研究中建立的各种干性AMD动物模型的特点进行综述.     

年龄相关性黄斑变性血浆蛋白质组学初步研究

目的 应用比较蛋白质组学技术,从蛋白质水平初步探讨年龄相关性黄斑变性(age-related macular degeneration,AMD)的发病机静.方法 门诊确诊湿性AMD组患者13例(18眼)、干性AMD组患者11例(17眼),6名健康志愿者作为对照组.采集外周血,用双向凝胶电泳结合质谱分析、生物信息学分析方法对各组患者血浆蛋白进行比较蛋白质组学分析.结果 正常对照组、干性AMD组、湿性AMD组中各样品图谱蛋白点平均匹配率分别为91.5％、92.2％、92.9％.发现有219个蛋白质斑点在3组凝胶中差异有统计学意义,获得有效鉴定及临床意义的蛋白质共28种.湿性AMD存在明显的补体激活、细胞生长因子相对高表达、细胞增生作用增强、抗损伤功能降低,而代谢障碍及抗氧化功能降低在干性及湿性AMD均存在.炎症损伤及由此触发的细胞增生在湿性AMD的发病过程中起了重要作用.结论 AMD患者血浆蛋白表达的改变,有助于阐明AMD发病机制,还可能作为AMD的治疗靶点,对早期诊断和治疗有意义.     

干性年龄相关性黄斑变性治疗的研究进展

年龄相关性黄斑变性(age-related macular degeneration,AMD)是60岁以上老年人视力不可逆性损伤的首要原因,其发病率随着年龄的增加而增高.干性AMD是AMD最常见的一种类型,它会引起视力逐渐下降,病情进展非常缓慢,干性AMD病程发展到晚期时,出现地图样萎缩,中心视力也会缺失.目前普遍认为其发病机制主要由慢性炎症损伤、氧化应激损伤、脂褐质沉积及玻璃膜疣形成、脉络膜血供不足等引起,针对病因治疗是当前主要治疗方案,但一些新的治疗方法如番红花酸、姜黄色素、睫状神经营养因子、纳米二氧化铈和人单克隆抗体、光感受器及干细胞移植等目前均用于治疗干性AMD.本文就干性AMD治疗的研究进展进行综述.     

干性年龄相关性黄斑变性的治疗进展

年龄相关性黄斑变性(AMD)可以引起不可逆的严重视力损害.目前对湿性AMD的诊断和治疗进行了大量的基础和临床研究,而对于干性AMD迄今尚无有效的治疗和预防措施.干性AMD在后期可以进展为黄斑区脉络膜新生血管(CNV)或地图样萎缩(GA),从而导致严重的视力损害.近年来出现的一些新的治疗策略主要集中在防止感光细胞和视网膜色素上皮(RPE)的损伤方面,如药物治疗、激光治疗、手术治疗、血浆置换以及干细胞和基因治疗等,有望对干性AMD的治疗带来新的希望.就干性AMD的治疗进展进行综述.     

干性年龄相关性黄斑变性的药物治疗最新研究进展

年龄相关性黄斑变性(age-related macular degeneration,AMD)是西方国家老年人低视力和致盲的主要病因,AMD已成为眼科学研究的热点。根据临床及病理表现,可将AMD分为干性和湿性两种类型,干性约占90%。因此,本文针对干性AMD的病理生理机制及新近的药物治疗方法进行了分析总结。为今后ADM的治疗提出依据。     

从VEGF在湿性年龄相关性黄斑变性发病过程中的作用机制看抗VEGF药物治疗

年龄相关性黄斑变性(AMD)的发病机制较复杂,其中湿性AMD对视力的威胁更为严重,其主要病理特征是黄斑区脉络膜的新生血管形成,血管内皮细胞生长因子( VEGF)在发病和新生血管的发展过程中发挥着重要作用.湿性AMD的物理治疗方法较多,但均无法改善患者的视力,近年来拮抗VEGF作用的药物疗法成为湿性AMD治疗的新途径.抗VEGF单克隆抗体是目前临床上应用较多的药物,能够消除新生血管,改善患者视力.针对VEGF其他环节的药物,如VEGF捕获剂、小分子干扰RNA及酪氨酸激酶抑制剂等,正处于试验阶段,其治疗效果值得期待.由于这些药物均为抗VEGF的制剂,因此充分了解VEGF在湿性AMD发病和发展过程中的作用机制有助于合理使用这些药物.     

程序性细胞死亡的分子机制及其与干性年龄相关性黄斑变性的关系

干性年龄相关性黄斑变性 (AMD) 是一种与年龄高度相关的退行性眼底病变,视网膜色素上皮细胞死亡是AMD致病的主要原因。程序性细胞死亡是一类由特定基因介导并调控的细胞死亡过程,在人体生长发育和疾病发病过程中起着重要的作用。越来越多的研究表明,程序性细胞死亡在AMD的发生发展中起着关键的作用。本文对当前5种常见的程序性细胞死亡的分子机制及其与干性AMD的关系进行综述。     

年龄相关性黄斑变性的发病机制及治疗的研究

年龄相关性黄斑变性(age-relatedmaculardegeneration,AMD),又称老年性黄斑变性,是西方发达国家最常见的致盲性眼病,常在50岁以后发病,且有逐年增加之趋势。临床上分干性和湿性两型,其中干性又称非渗出性,以黄斑区地图状萎缩为特征;而湿性又称渗出性,以脉络膜新生血管形成(CNV)为特征,常引起黄斑区出血、纤维瘢痕化,因此,湿性AMD是引起视力丧失的最主要原因。目前,其病因不明,也无有效治疗方法。因此,探索AMD的发病机制及治疗手段是当前的研究热点。一、发病机制的研究目前认为,AMD是—种由多因素引起的疾病,其病因分为全身因素和眼局…     

嘌呤能信号在干性年龄相关性黄斑变性中损伤作用的研究进展

年龄相关性黄斑变性(AMD)是65岁以上人群重要的致盲眼病, 其中干性AMD发病机制复杂, 目前仍缺乏有效治疗手段。嘌呤能信号通路广泛存在于视网膜环境中, 具有信号传导与神经调节的作用, 其可诱导视网膜细胞死亡, 调控小胶质细胞活性, 参与炎症和氧化应激反应、病理沉积物的生成以及视网膜水肿等病理反应, 参与干性AMD的发展过程。本文就嘌呤能信号通路组成分子在RPE、光感受器等多种视网膜细胞的死亡、小胶质细胞的活化调节、病理沉积物的生成以及炎症和氧化应激等多个干性AMD损伤机制的调控中的作用进行综述, 以期为临床开展相关研究提供参考。     

干性年龄相关性黄斑变性患者视网膜色素上皮细胞损伤机制

年龄相关性黄斑变性(age-related macular degeneration,AMD)是中老年人视力障碍的重要原因之一。AMD分为2型:萎缩型(干性)和渗出型(湿性)。本文从光照损伤、脂褐素积累、氧化损伤、内质网应激4个方面,综述了干性AMD研究中基于视网膜色素上皮细胞损伤的相关研究进展,为进一步探索其发病机制提供依据和方向。     

湿性年龄相关性黄斑变性的治疗进展

年龄相关性黄斑变性( age-related macular degeneration, AMD)是WHO现阶段三大防盲重点眼病之一,是50岁以上人群主要的致盲眼病之一,65岁以上的人群中,约2%因患本病而导致单眼失明,随着人口老龄化,我国AMD的患病率也在增加。 AMD就其临床表现分为干性 AMD和湿性AMD,湿性AMD对患者的视力危害最大,目前AMD的治疗很多(主要是针对湿性AMD),主要包括激光治疗、药物治疗、手术治疗、基因治疗等,以下对近年来湿性AMD的治疗作一综述。     

Prevalence of Age-Related Macular Degeneration in Slovakia and Associated Risk Factors: A Mobile Clinic-Based Cross-Sectional Epidemiological Survey

Purpose: Age-related macular degeneration (AMD) is one of the leading causes of blindness in the elderly population. Although there are prevalence studies for AMD in Europe, data are scarce for the Slovakian population. Methods: This was a prospective, multicenter, non-interventional, mobile clinic-based cross-sectional study that assessed age-specific prevalence of AMD in the Slovakian population and risk factors associated with AMD. The type of AMD was graded based on the international age-related maculopathy grading system; optical coherence tomography (OCT) was used for the differential diagnosis. Overall, 3,278 patients were screened; the fundus photographs, OCT scans, and self-reports were collected at the mobile clinic in a single visit. Results: The prevalence of AMD in the study population was 8.99% (wet AMD 1.01%; dry AMD 7.85%), whereas the extrapolated estimate in the entire Slovakian population was 3.3% (wet AMD 0.3%; dry AMD 3.0%). Age, smoking, and hypertension were risk factors associated with AMD; however, contrary to reports in the literature, no gender-specific association was observed. Conclusion: Based on the results of this study, mobile clinics may be an effective way to extend health care access to a larger population. Early diagnosis of AMD will assist in early treatment and effective disease management of the population at risk.     

Monitoring of AMD patients on anti-vascular endothelial growth factor (VEGF) treatment. Practical notes on functional and anatomical examination parameters from drug approval studies, specialist information and case series

Age-related macular degeneration (AMD) is one of the most common causes of blindness in western industrialised nations. Most AMD patients suffer from the dry early form of AMD; however, wet AMD with choroidal neovascularization (CNV) is the main cause of blindness in all AMD patients. New prospects have been developed in AMD treatment using pharmacological methods available for treating all subtypes of exudative AMD. A number of inhibiting and inducing growth factors, such as vascular endothelial growth factor (VEGF), are particularly important in the pathophysiology of wet AMD. The secreted VEGF appears to play a crucial role in the pathogenesis of CNV and macular edemas as a result of its angiogenetic and permeability-enhancing effect. This recognition led to the treatment approach now used, i.e., competitive VEGF blocking through intravitreal adminsitration of anti-VEGF drugs. The anti-VEGF durgs lead to a rapid decrease in retinal thickness. Optical coherence tomography (OCT) is a valuable monitoring tool, but may only be used to assist in decision-making. Clinical follow-up of patients and further treatment recommendations must always be guided by the overall clinical picture. Visual acuity is regarded as the decisive criterion for repeat treatment.     

Monitoring von AMD-Patienten unter Anti-VEGF-Therapie

Age-related macular degeneration (AMD) is one of the most common causes of blindness in western industrialised nations. Most AMD patients suffer from the dry early form of AMD; however, wet AMD with choroidal neovascularization (CNV) is the main cause of blindness in all AMD patients. New prospects have been developed in AMD treatment using pharmacological methods available for treating all subtypes of exudative AMD. A number of inhibiting and inducing growth factors, such as vascular endothelial growth factor (VEGF), are particularly important in the pathophysiology of wet AMD. The secreted VEGF appears to play a crucial role in the pathogenesis of CNV and macular edemas as a result of its angiogenetic and permeability-enhancing effect. This recognition led to the treatment approach now used, i.e., competitive VEGF blocking through intravitreal adminsitration of anti-VEGF drugs. The anti-VEGF durgs lead to a rapid decrease in retinal thickness. Optical coherence tomography (OCT) is a valuable monitoring tool, but may only be used to assist in decision-making. Clinical follow-up of patients and further treatment recommendations must always be guided by the overall clinical picture. Visual acuity is regarded as the decisive criterion for repeat treatment.     

HTRA1 variant increases risk to neovascular age-related macular degeneration in Chinese population

Age-related macular degeneration (AMD) is a leading cause of irreversible visual impairment in the world. Advanced AMD can be divided into wet AMD (choroidal neovascularization) and dry AMD (geographic atrophy, GA). Drusen is characterized by deposits in the macula without visual loss and is an early AMD sign in the Caucasian population. rs11200638 in the promoter of HTRA1 has recently been shown to increases the risk for wet AMD in both Caucasian and Hong Kong Chinese populations. In order to replicate these results in a different cohort, we genotyped rs11200638 for 164 Chinese patients (90 wet AMD and 74 drusen) and 106 normal controls in a Han Mainland Chinese cohort. The genotypes were compared using chi square analysis for an additive allelic model. rs11200638 was significantly associated with wet AMD (p=5.00x10(-12)). Unlike in the Caucasian population, the risk allele of rs11200638 was not associated with drusen in our Chinese population. These findings confirm the association of HTRA1 with wet AMD.     

Pharmacological treatment of dry age-related macular degeneration (AMD)

As the population grows older each year, age-related macular degeneration (AMD) is becoming the leading eye disease resulting in blindness. Although some drugs are available for the treatment of wet AMD, no drug is currently available for dry AMD. Actual research is taking place to invent novel drug for the treatment of dry AMD and the hurdles of the R&D are reviewed. Literature search and review were conducted to identify various ideas to treat dry AMD and to overcome the difficulties of developing clinical end points for developing the new drugs. Some promising drug candidates had been identified and clinical end points of drug efficacy determination had been collected. With the proof of new concepts and clinical end points available, the hope is high to expect some new novel drugs be put in the market sometime in the future.     

湿性年龄相关性黄斑变性的治疗现状

年龄相关性黄斑变性（age-related macular degeneration,AMD）是50岁以上人群主要致盲眼病之一, 与干性AMD相比,湿性AMD病情发展更为迅速,是引起视力下降甚至丧失的主要原因。湿性AMD的治疗主要包括激光治疗、手术治疗、药物治疗、放射治疗及基因治疗。其中光动力疗法以及抗血管内皮生长因子药物的应用成为近年来湿性AMD治疗的热点,而抗血小板源性生长因子药物、放射治疗及基因治疗为湿性AMD的治疗提供了新思路。     

Assessment of macular pigment optical density (MPOD) in patients with unilateral wet age‐related macular degeneration (AMD)

Purpose: To compare the macular pigment optical density (MPOD) of patients with unilateral wet age‐related macular degeneration (AMD) with the MPOD of bilateral dry AMD patients and healthy elderly individuals. Methods: The MPOD of 34 patients with unilateral wet AMD was measured in their fellow eye that had the dry form of the disease (study group). The MPOD of the study group was compared with the MPOD of 33 patients with bilateral dry AMD (patients’ control group) and 35 elderly subjects without any signs of retinal disease (control group). None of the subjects was under carotenoid supplementation. The MPOD was measured with Heterochromatic Flicker Photometry [QuantifEYE?– MPS 9000 (ZeaVision^©)]. The statistical package SPSS v 17.0 was used for the analysis. Results: The overall mean MPOD was 0.52 (SD 0.15). Patients with unilateral wet AMD have significantly higher levels of MPOD in their fellow eye compared with patients with bilateral dry AMD (0.58 versus 0.48, p = 0.026). Mean MPOD of patients with bilateral dry AMD does not differ significantly from that of healthy elderly subjects (0.48 versus 0.50, p = 0.865). In this population sample, no correlation with age was observed, while women have slightly but significantly higher levels of MPOD (0.55 versus 0.49, p = 0.029). Conclusion: In the present study, the mean MPOD at the fellow eye of patients with unilateral wet AMD was found to be significantly higher than that of patients with bilateral dry AMD, while no other significant difference emerged between groups. Further investigation is demanded to clarify the role of macular pigment in AMD progression.