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International Journal of Molecular... Dec 2020Age-related macular degeneration (AMD) is the major reason for blindness in the industrialized world with limited treatment options. Important pathogenic pathways in AMD... (Review)
Review
Age-related macular degeneration (AMD) is the major reason for blindness in the industrialized world with limited treatment options. Important pathogenic pathways in AMD include oxidative stress and vascular endothelial growth factor (VEGF) secretion. Due to their bioactivities, fucoidans have recently been suggested as potential therapeutics. This review gives an overview of the recent developments in this field. Recent studies have characterized several fucoidans from different species, with different molecular characteristics and different extraction methods, in regard to their ability to reduce oxidative stress and inhibit VEGF in AMD-relevant in vitro systems. As shown in these studies, fucoidans exhibit a species dependency in their bioactivity. Additionally, molecular properties such as molecular weight and fucose content are important issues. Fucoidans from and were identified as the most promising candidates for further development. Further research is warranted to establish fucoidans as potential therapeutics for AMD.
Topics: Animals; Disease Management; Disease Susceptibility; Humans; Macular Degeneration; Oxidative Stress; Polysaccharides; Research; Retinal Pigment Epithelium
PubMed: 33291752
DOI: 10.3390/ijms21239272 -
Nature Communications Jul 2019Age-related macular degeneration (AMD) is the most common cause of blindness among the elderly in the developed world. While treatment is effective for the neovascular... (Review)
Review
Age-related macular degeneration (AMD) is the most common cause of blindness among the elderly in the developed world. While treatment is effective for the neovascular or "wet" form of AMD, no therapy is successful for the non-neovascular or "dry" form. Here we discuss the current knowledge on dry AMD pathobiology and propose future research directions that would expedite the development of new treatments. In our view, these should emphasize system biology approaches that integrate omic, pharmacological, and clinical data into mathematical models that can predict disease onset and progression, identify biomarkers, establish disease causing mechanisms, and monitor response to therapy.
Topics: Animals; Humans; Macular Degeneration; Oxidative Stress; Systems Biology
PubMed: 31350409
DOI: 10.1038/s41467-019-11262-1 -
Optometry Clinics : the Official... 1996A general overview of age-related macular degeneration, including its definition, classification, and epidemiology, is followed by specifically described clinical... (Review)
Review
A general overview of age-related macular degeneration, including its definition, classification, and epidemiology, is followed by specifically described clinical findings of this disorder. Included are the differential diagnosis, histopathology, prevalence, risk factors, and natural history of each individual form. Also presented are the issues of optometric management, including clinical recognition of choroidal neovascularization, timely referral for retinal consultation and angiography, preventive therapies, current and emerging trends in the medical and surgical treatment, and appropriate follow-up.
Topics: Aging; Humans; Macular Degeneration; Preventive Medicine; Risk Factors
PubMed: 8963078
DOI: No ID Found -
Clinical & Experimental Optometry Mar 2018Age-related macular degeneration is a common, complex and blinding eye disease. When early and intermediate levels of severity are detected in one or both eyes, there is... (Review)
Review
Age-related macular degeneration is a common, complex and blinding eye disease. When early and intermediate levels of severity are detected in one or both eyes, there is a wide-ranging 0.4 to 53 per cent risk of progression to advanced disease in five years. In order to maximise visual outcomes for their patients, practising eye-care professionals must be able to stratify patients according to their risk of progression, intervene (for example by recommending smoking cessation or nutritional supplements and Amsler grid self-monitoring in intermediate disease) and monitor accordingly. With the aid of ocular imaging, a range of under-recognised yet meaningful risk factors have been identified. The purpose of this review is to assist the eye-care practitioner in stratifying the risk of progression in intermediate age-related macular degeneration using the range of established and emerging precursory signs that herald loss of vision.
Topics: Biomarkers; Disease Progression; Humans; Macular Degeneration; Prognosis; Risk Factors; Tomography, Optical Coherence
PubMed: 29136680
DOI: 10.1111/cxo.12624 -
Journal of Ocular Pharmacology and... Sep 2015The cardinal features of age-related macular degeneration (AMD) are the accumulation of subretinal debris, subretinal inflammation, neovascularization, and degeneration... (Review)
Review
The cardinal features of age-related macular degeneration (AMD) are the accumulation of subretinal debris, subretinal inflammation, neovascularization, and degeneration of the photoreceptors and retinal pigment epithelium (RPE). Thrombospondin-1 (TSP-1) is a major matricellular protein that is physiologically expressed in the RPE and choroid, but severely diminished in eyes with AMD. TSP-1 plays an important role in phagocytosis, potently inhibits neovascularization, and mediates immune suppression and immune privilege. The lack of TSP-1 could have a central role in the pathogenesis of AMD as it is implicated in the major pathways that seem to be deficient in the disease. We here give an overview of the major functions of TSP-1 and how it could intervene in AMD pathogenesis.
Topics: Animals; Humans; Macular Degeneration; Thrombospondin 1
PubMed: 26062001
DOI: 10.1089/jop.2015.0023 -
Geriatric Nursing (New York, N.Y.) 2007Macular degeneration is the most common cause of blindness in individuals over 50 years of age. The condition is frequently classified into the categories of early,... (Review)
Review
Macular degeneration is the most common cause of blindness in individuals over 50 years of age. The condition is frequently classified into the categories of early, intermediate, and advanced stages. Current interventions concerning macular degeneration include a healthy lifestyle, diet, medical intervention, surgery, and environmental assistance. Future strategies for individuals with macular degeneration will possibly stress gene therapy, retinal transplantation, artificial vision, retinal prosthesis, and neuroprotection.
Topics: Diet; Humans; Macular Degeneration; Self-Help Devices
PubMed: 18068822
DOI: 10.1016/j.gerinurse.2007.03.003 -
Cold Spring Harbor Perspectives in... Aug 2014Understanding genetic causes of age-related macular degeneration (AMD) will eventually yield effective discoveries and improvements in predictive/prognostic methods.... (Review)
Review
Understanding genetic causes of age-related macular degeneration (AMD) will eventually yield effective discoveries and improvements in predictive/prognostic methods. These include, but are not limited to, reliable disease prediction (screening for increased discrimination of clinical risk), differential classification of AMD subtypes with biomarkers (development of risk-linked molecular taxonomies), selection of optimal preventive and therapeutic interventions (guided by a biologically meaningful understanding of treatment response), and drug dosing. In this review, we discuss clinical applications informed by key findings in AMD genetics, and provide commentary on leveraging extant and forthcoming evidence to improve AMD risk prediction, AMD classification, and knowledge on the genetic basis of drug activity and toxicity. Advances in translating AMD genetics findings for AMD risk prediction require development of a genetics-based causality for AMD incidence and progression. Molecular subtyping of AMD phenotypes requires a set of dynamic biomarkers presenting prognostic value; although these have yet to be identified, the formation of multidisciplinary teams and their participation in large-scale consortia may yield promising results. Drugs targeting complement and vascular endothelial growth factor (VEGF) systems are under evaluation, and forthcoming work on rare variants and noncoding DNA in AMD pathogenesis will likely reveal biochemical pathways enriched with AMD-associated genetic variants. Pharmacologic targets in these pathways may inform a rational and effective therapeutic approach to preventing and treating this sight-threatening disease.
Topics: Aging; Biomarkers; Complement System Proteins; Genetic Variation; Humans; Macular Degeneration; Phenotype; Prognosis; Risk Factors; Vascular Endothelial Growth Factor A
PubMed: 25125423
DOI: 10.1101/cshperspect.a017228 -
Survey of Ophthalmology 2003Age-related macular degeneration is the principal cause of registered legal blindness among those aged over 65 in the United States, western Europe, Australia, and... (Review)
Review
Age-related macular degeneration is the principal cause of registered legal blindness among those aged over 65 in the United States, western Europe, Australia, and Japan. Despite intensive research, the precise etiology of molecular events that underlie age-related macular degeneration is poorly understood. However, investigations on parallel fronts are addressing this prevalent public health problem. Sophisticated biochemical and biophysical techniques have refined our understanding of the pathobiology of drusen, geographic atrophy, and retinal pigment epithelial detachments. Epidemiological identification of risk factors has facilitated an intelligent search for underlying mechanisms and fueled clinical investigation of behavior modification. Gene searches have not only brought us to the cusp of identifying the culpable gene loci in age-related macular degeneration, but also localized genes responsible for other macular dystrophies. Recent and ongoing investigations, often cued by tumor biology, have revealed an important role for various growth factors, particularly in the neovascular form of the condition. Transgenic and knockout studies have provided important mechanistic insights into the development of choroidal neovascularization, the principal cause of vision loss in age-related macular degeneration. This in turn has culminated in preclinical and clinical trials of directed molecular interventions.
Topics: Animals; Disease Models, Animal; Humans; Macular Degeneration; Mice; Mice, Knockout; Mice, Transgenic; Risk Factors
PubMed: 12745003
DOI: 10.1016/s0039-6257(03)00030-4 -
The Consultant Pharmacist : the Journal... Nov 2013Review the current recommendations for the prevention and treatment of age-related macular degeneration (AMD). (Review)
Review
OBJECTIVE
Review the current recommendations for the prevention and treatment of age-related macular degeneration (AMD).
DATA SOURCES
Articles indexed in PubMed (National Library of Medicine), the Cochrane Reviews and Trials, Dynamed, and Iowa Drug Information Service (IDIS) in the last 10 years using the key words macular degeneration, agerelated macular degeneration (AMD), AMD and treatment, AMD and prevention.
STUDY SELECTION AND DATA EXTRACTION
Sixty-nine published papers were reviewed, and criteria supporting the primary objective were used to identify useful resources.
DATA SYNTHESIS
The literature included practice guidelines, original research articles, review articles, product prescribing information, and supplement product information for the prevention and treatment of AMD.
CONCLUSION
AMD is a leading cause of visual impairment in older adults. At present there is no cure for advanced AMD, but intravitreal vascular endothelial growth factor inhibitors minimize and even reverse vision loss in patients with AMD of the neovascular type. In the Age-Related Eye Disease Study (AREDS), participants with intermediate AMD who received a supplement combination of vitamins C and E, beta-carotene, and zinc had a greater delay in progression to advanced AMD than those participants who received a portion of these supplements. In the second AREDS, AREDS2, the addition of lutein + zeaxanthin, docosahexaenoic acid (DHA) + eicosapentaenoic acid (EPA), or lutein + zeaxanthin and DHA + EPA to the complete AREDS formulation did not further reduce the risk of progression to advanced AMD. Subgroup analyses indicated that additional research with lutein + zeaxanthin supplementation is warranted as it was beneficial in participants with low dietary intake of lutein + zeaxanthin. A formulation without beta-carotene may be best for most patients, especially smokers or former smokers. Health care professionals will want to consider patient-specific information before recommending ocular health supplements.
Topics: Age Factors; Disease Progression; Humans; Intravitreal Injections; Macular Degeneration; Practice Guidelines as Topic; Vascular Endothelial Growth Factor A; Wet Macular Degeneration
PubMed: 24217192
DOI: 10.4140/TCP.n.2013.723 -
Ophthalmology. Retina Aug 2022
Topics: Humans; Macular Degeneration; Retinal Detachment
PubMed: 35933123
DOI: 10.1016/j.oret.2022.05.003