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Age-related macular degeneration--emerging pathogenetic and therapeutic concepts.
Ann Med. 2006; 38(7):450-71.AM

Abstract

Today, the average life expectancy in developed nations is over 80 years and climbing. And yet, the quality of life during those additional years is often significantly diminished by the effects of age-related, degenerative diseases, including age-related macular degeneration (AMD), the leading cause of blindness in the elderly worldwide. AMD is characterized by a progressive loss of central vision attributable to degenerative and neovascular changes in the macula, a highly specialized region of the ocular retina responsible for fine visual acuity. Estimates gathered from the most recent World Health Organization (WHO) global eye disease survey conservatively indicate that 14 million persons are blind or severely visually impaired because of AMD. The disease has a tremendous impact on the physical and mental health of the geriatric population and their families and is becoming a major public health burden. Currently, there is neither a cure nor a means to prevent AMD. Palliative treatment options for the less prevalent, late-stage 'wet' form of the disease include anti-neovascular agents, photodynamic therapy and thermal laser. There are no current therapies for the more common 'dry' AMD, except for the use of antioxidants that delay progression in 20%-25% of eyes. New discoveries, however, are beginning to provide a much clearer picture of the relevant cellular events, genetic factors, and biochemical processes associated with early AMD. Recently, compelling evidence has emerged that the innate immune system and, more specifically, uncontrolled regulation of the complement alternative pathway plays a central role in the pathobiology of AMD. The complement Factor H gene--which encodes the major inhibitor of the complement alternative pathway--is the first gene identified in multiple independent studies that confers a significant genetic risk for the development of AMD. The emergence of this new paradigm of AMD pathogenesis should hasten the development of novel diagnostic and therapeutic approaches for this disease that will dramatically improve the quality of our prolonged lifespan.

Authors+Show Affiliations

Department of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, IA 52240, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

17101537

Citation

Gehrs, Karen M., et al. "Age-related Macular Degeneration--emerging Pathogenetic and Therapeutic Concepts." Annals of Medicine, vol. 38, no. 7, 2006, pp. 450-71.
Gehrs KM, Anderson DH, Johnson LV, et al. Age-related macular degeneration--emerging pathogenetic and therapeutic concepts. Ann Med. 2006;38(7):450-71.
Gehrs, K. M., Anderson, D. H., Johnson, L. V., & Hageman, G. S. (2006). Age-related macular degeneration--emerging pathogenetic and therapeutic concepts. Annals of Medicine, 38(7), 450-71.
Gehrs KM, et al. Age-related Macular Degeneration--emerging Pathogenetic and Therapeutic Concepts. Ann Med. 2006;38(7):450-71. PubMed PMID: 17101537.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Age-related macular degeneration--emerging pathogenetic and therapeutic concepts. AU - Gehrs,Karen M, AU - Anderson,Don H, AU - Johnson,Lincoln V, AU - Hageman,Gregory S, PY - 2006/11/15/pubmed PY - 2007/3/3/medline PY - 2006/11/15/entrez SP - 450 EP - 71 JF - Annals of medicine JO - Ann Med VL - 38 IS - 7 N2 - Today, the average life expectancy in developed nations is over 80 years and climbing. And yet, the quality of life during those additional years is often significantly diminished by the effects of age-related, degenerative diseases, including age-related macular degeneration (AMD), the leading cause of blindness in the elderly worldwide. AMD is characterized by a progressive loss of central vision attributable to degenerative and neovascular changes in the macula, a highly specialized region of the ocular retina responsible for fine visual acuity. Estimates gathered from the most recent World Health Organization (WHO) global eye disease survey conservatively indicate that 14 million persons are blind or severely visually impaired because of AMD. The disease has a tremendous impact on the physical and mental health of the geriatric population and their families and is becoming a major public health burden. Currently, there is neither a cure nor a means to prevent AMD. Palliative treatment options for the less prevalent, late-stage 'wet' form of the disease include anti-neovascular agents, photodynamic therapy and thermal laser. There are no current therapies for the more common 'dry' AMD, except for the use of antioxidants that delay progression in 20%-25% of eyes. New discoveries, however, are beginning to provide a much clearer picture of the relevant cellular events, genetic factors, and biochemical processes associated with early AMD. Recently, compelling evidence has emerged that the innate immune system and, more specifically, uncontrolled regulation of the complement alternative pathway plays a central role in the pathobiology of AMD. The complement Factor H gene--which encodes the major inhibitor of the complement alternative pathway--is the first gene identified in multiple independent studies that confers a significant genetic risk for the development of AMD. The emergence of this new paradigm of AMD pathogenesis should hasten the development of novel diagnostic and therapeutic approaches for this disease that will dramatically improve the quality of our prolonged lifespan. SN - 0785-3890 UR - https://www.unboundmedicine.com/medline/citation/17101537/Age_related_macular_degeneration__emerging_pathogenetic_and_therapeutic_concepts_ L2 - https://www.tandfonline.com/doi/full/10.1080/07853890600946724 DB - PRIME DP - Unbound Medicine ER -