ADVANCED GLYCATION ENDPRODUCTS: BIOMARKERS FOR AGE-RELATED MACULAR DEGENERATION

摘要

Age-related macular degeneration (AMD) is a complex, progressive disease involving multiple genetic and environmental factors and a major cause of severe visual loss in the elderly worldwide. Deposition of debris (drusen) along Bruch's membrane in the macula (Figure 1) is the first evidence of early AMD. Advanced AMD occurs in two forms, geographic atrophy and choroidal neovascularization. Geographic atrophy (advanced dry AMD) develops slowly and results in blindness when focal areas of the retinal pigment epithelium (RPE) degenerate in the macula. Choroidal neovascularization (wet AMD) is characterized by the growth of new blood vessels from the choroid through Bruch's membrane and the RPE. When these vessels hemorrhage, a blood clot accumulates between the RPE and the macular photoreceptors, causing immediate central vision loss. Wet AMD accounts for over 80% of debilitating visual loss in AMD yet only 10-15% of AMD cases progress to neovascular AMD.