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Journal of the American Academy of... May 2002To enhance nurse practitioner (NP) recognition of clients with age-related macular degeneration (AMD) based on history and physical examination findings, to encourage... (Review)
Review
PURPOSE/OBJECTIVE
To enhance nurse practitioner (NP) recognition of clients with age-related macular degeneration (AMD) based on history and physical examination findings, to encourage prompt initial referral of these clients to an ophthalmologist for a treatment evaluation, and to acquaint NPs with low vision rehabilitation services.
DATA SOURCES
Government documents, professional association practice guidelines, original research articles, journal articles, and Internet resources.
CONCLUSIONS
Age-related macular degeneration is a common, chronic vision-threatening condition necessitating prompt recognition and professional evaluation. If not recognized early, AMD can lead to low vision and a diminished quality of life for the elderly client.
IMPLICATIONS FOR PRACTICE
Even though NPs have a limited role in the treatment of AMD, they are in an instrumental position as a primary care providers to screen for this disease chiefly by: (a) adherence to eye examinations intervals, (b) recognition of risk factors, (c) use of the Amsler grid, (d) awareness of psychosocial dimensions, (e) making appropriate referrals, and (f) advocating low vision rehabilitation services.
Topics: Age Factors; Aged; Disease Progression; Humans; Macular Degeneration; Nurse Practitioners; Quality of Life; Risk Factors
PubMed: 12051144
DOI: 10.1111/j.1745-7599.2002.tb00115.x -
Pharmacogenomics Apr 2018Nonresponsiveness to age-related macular degeneration (AMD) treatments has become a growing concern in ophthalmology. Disparity among publications that have assessed... (Review)
Review
Nonresponsiveness to age-related macular degeneration (AMD) treatments has become a growing concern in ophthalmology. Disparity among publications that have assessed pharmacogenetic (PGx) connections between AMD disease genes and treatments has delayed the implementation of PGx testing in AMD. We assessed all AMD PGx publications to identify the degree of agreement for publications within similar ethnic cohorts and worldwide, and the causes for differences in study outcomes. There are no accepted genotype-phenotype correlations, either within similar ethnic cohorts or worldwide. The diversity of measured outcomes, treatment protocols and statistical methods used may be causing this discrepancy. A universally accepted treatment protocol and the creation of agreed response group classification may bridge the gap between AMD PGx publications.
Topics: Aging; Humans; Macular Degeneration; Pharmacogenomic Testing; Treatment Failure
PubMed: 29577807
DOI: 10.2217/pgs-2017-0183 -
Current Opinion in Pharmacology Apr 2024To develop effective therapies for complex blinding diseases such as age-related macular degeneration (AMD), identification of mechanisms involved in its initiation and... (Review)
Review
To develop effective therapies for complex blinding diseases such as age-related macular degeneration (AMD), identification of mechanisms involved in its initiation and progression is needed. The estrogen-related receptor alpha (ESRRA) is an orphan nuclear receptor that regulates several AMD-associated pathogenic pathways. However, it has not been investigated in detail in the ocular posterior pole during aging or in AMD. This review delves into the literature highlighting the significance of ESRRA as a molecular target that may be important in the pathobiology of AMD, and discusses data available supporting the targeting of this receptor signaling pathway as a therapeutic option for AMD.
Topics: Humans; ERRalpha Estrogen-Related Receptor; Macular Degeneration; Aging; Receptors, Cytoplasmic and Nuclear; Eye
PubMed: 38447458
DOI: 10.1016/j.coph.2024.102439 -
Optometry and Vision Science : Official... Aug 2014
Topics: Biomedical Research; Early Diagnosis; Humans; Macular Degeneration; Risk Factors
PubMed: 25058632
DOI: 10.1097/OPX.0000000000000337 -
Neuropharmacology May 2021The prevalence of age-related macular degeneration (AMD) has increased in the last years. Although anti-VEGF agents have improved the prognosis of exudative AMD, dry AMD... (Review)
Review
The prevalence of age-related macular degeneration (AMD) has increased in the last years. Although anti-VEGF agents have improved the prognosis of exudative AMD, dry AMD has still devastating effects on elderly people vision. Oxidative stress and inflammation are mechanisms involved in AMD pathogenesis and its progression. Molecular pathways involving epidermal growth factor receptor (EGFR), bone morphogenetic protein (BMP4) and the nuclear erythroid related factor 2 (Nrf2) are behind oxidative stress in AMD due to their participation in antioxidant cellular pathways. As a consequence of the disbalance produced in the antioxidant mechanisms, there is an activation of innate and adaptative immune response with cell recruitment, changes in complement factors expression, and modification of cellular milieu. Different therapies are being studied to treat dry AMD based on the possible effects on antioxidant molecular pathways or their action on the immune response. There is a wide range of treatments presented in this review, from natural antioxidant compounds to cell and gene therapy, based on their mechanisms. Finally, we hypothesize that alpha-1-antitrypsin (AAT), an anti-inflammatory and immunomodulatory molecule that can also modulate antioxidant cellular defenses, could be a good candidate for testing in AMD. This article is part of the special ssue on 'The Quest for Disease-Modifying Therapies for Neurodegenerative Disorders'.
Topics: Aging; Animals; Antioxidants; Humans; Macular Degeneration; Oxidative Stress
PubMed: 33662390
DOI: 10.1016/j.neuropharm.2021.108513 -
Current Opinion in Ophthalmology May 2010To review and compare the various therapeutic platforms, investigational drugs, and clinical trials targeting geographic atrophy in age-related macular degeneration. (Review)
Review
PURPOSE OF REVIEW
To review and compare the various therapeutic platforms, investigational drugs, and clinical trials targeting geographic atrophy in age-related macular degeneration.
RECENT FINDINGS
Investigational agents based on hypothesized causes are being developed to treat geographic atrophy. These platforms are designed to attack the disease on several different fronts.
SUMMARY
As knowledge of geographic atrophy pathophysiology advances, targeted pharmacotherapies may well be able to mitigate the retinal damage and vision loss associated with geographic atrophy.
Topics: Geographic Atrophy; Humans; Macular Degeneration
PubMed: 20216419
DOI: 10.1097/ICU.0b013e32833866c8 -
British Journal of Community Nursing Oct 2023The aim of this article is to explain age-related macular degeneration (AMD) and how it impacts on the wellbeing of patients in the community setting. It explores the...
The aim of this article is to explain age-related macular degeneration (AMD) and how it impacts on the wellbeing of patients in the community setting. It explores the anatomy and physiology associated with AMD, its symptoms and treatment, and goes on to discuss related nursing care.
Topics: Humans; Macular Degeneration
PubMed: 37793105
DOI: 10.12968/bjcn.2023.28.10.498 -
Clinical & Experimental Ophthalmology Apr 2022
Topics: Angiogenesis Inhibitors; Humans; Intravitreal Injections; Macular Degeneration; Ranibizumab; Retrospective Studies; Wet Macular Degeneration
PubMed: 35174600
DOI: 10.1111/ceo.14057 -
British Journal of Hospital Medicine... Dec 2005
Topics: Age Factors; Aged; Angiogenesis Inhibitors; Aptamers, Nucleotide; Audiovisual Aids; Fluorescein Angiography; Humans; Laser Therapy; Macular Degeneration; Photochemotherapy; Risk Factors
PubMed: 16417106
DOI: 10.12968/hmed.2005.66.12.20206 -
Progress in Retinal and Eye Research Nov 2013Age-related macular degeneration (AMD) is a disease of the outer retina, characterized most significantly by atrophy of photoreceptors and retinal pigment epithelium... (Review)
Review
Age-related macular degeneration (AMD) is a disease of the outer retina, characterized most significantly by atrophy of photoreceptors and retinal pigment epithelium accompanied with or without choroidal neovascularization. Development of AMD has been recognized as contingent on environmental and genetic risk factors, the strongest being advanced age. In this review, we highlight pathogenic changes that destabilize ocular homeostasis and promote AMD development. With normal aging, photoreceptors are steadily lost, Bruch's membrane thickens, the choroid thins, and hard drusen may form in the periphery. In AMD, many of these changes are exacerbated in addition to the development of disease-specific factors such as soft macular drusen. Para-inflammation, which can be thought of as an intermediate between basal and robust levels of inflammation, develops within the retina in an attempt to maintain ocular homeostasis, reflected by increased expression of the anti-inflammatory cytokine IL-10 coupled with shifts in macrophage plasticity from the pro-inflammatory M1 to the anti-inflammatory M2 polarization. In AMD, imbalances in the M1 and M2 populations together with activation of retinal microglia are observed and potentially contribute to tissue degeneration. Nonetheless, the retina persists in a state of chronic inflammation and increased expression of certain cytokines and inflammasomes is observed. Since not everyone develops AMD, the vital question to ask is how the body establishes a balance between normal age-related changes and the pathological phenotypes in AMD.
Topics: Aging; Bruch Membrane; Eye Diseases, Hereditary; Eye Proteins; Humans; Lipid Metabolism; Macular Degeneration; Oxidative Stress; Retinal Drusen
PubMed: 23933169
DOI: 10.1016/j.preteyeres.2013.07.003