干性年龄相关性黄斑变性的发病机制研究进展

摘要

Dry age-related macular degeneration ( AMD) is one of the major causes of blindness in the elderly population and it is the consequence of interactions of multiple factors.Although the pathogenesis of dry AMD hasn′t been fully elucidated , much progress has been made in the genetics , inflammation , oxidative stress,aging of retinal pigment epithelium (RPE) cells and metabolic changes.Identification of dry AMD related genes and predisposing loci facilitates the development of risk evaluation of dry AMD .Presence ofβ-amyloid in the drusen implies similarities between AMD and other degenerative diseases .Dysfunction of complement system, discovery of Nod-like receptor family containing pyrin domain 3 inflammasome and the concept of parainflammation reinforce the role of inflammation.Oxidative stress, mitochondrial dysfunction and decreased autophagy capacity , which are related to aging of RPE cells , demonstrate the critical role of it and metabolic changes in the pathogenesis.%干性AMD是老年人主要的致盲眼病之一，是多因素共同作用的结果。虽然目前干性AMD的发病机制尚未完全阐明，但是近年来在遗传、炎症、氧化应激、视网膜色素上皮（ RPE）细胞老化与代谢改变等方面的研究取得了不少进展。干性AMD相关基因及易感位点的确定推动了干性AMD风险评估的发展；玻璃膜疣中β淀粉样物质的存在揭示了干性AMD与其他退行性疾病的相关性；补体通路的调节异常、Nod样受体家族包含pyrin结构域蛋白3炎症因子的发现以及副反应炎症概念的提出进一步肯定炎症的作用；RPE细胞老化相关的氧化应激及线粒体异常、自噬功能下降等显示RPE细胞老化和代谢改变在干性AMD发病中的关键作用。（中华眼科杂志，2014，50：464-470）