Age-Related Macular Degeneration: An Exponentially Emerging Imminent Threat of Visual Impairment and Irreversible Blindness

Abstract

Age-related macular degeneration (AMD) is a significant cause of blindness globally. With the exponential rise in the aging population, AMD is the third leading cause of visual impairment worldwide. Neovascular AMD (nAMD; Wet AMD) and geographical atrophy (GA, late-stage dry AMD) are the advanced AMD accountable for substantial cases of visual deterioration among the elderly. Our review of the literature depicted that notable risk factors include cigarette smoking, nutritional elements, cardiovascular disorders, and genetic markers, including genes regulating complement, lipid, and angiogenic pathways. Some studies have suggested a relative decline in the proportion of AMD cases in the last two decades attributable to novel diagnostic and therapeutic modalities. Accurate diagnosis is the result of a combination of clinical examination and imaging techniques, including retinal photography, angiography, and optical coherence tomography. The incorporation of dietary antioxidant supplements, explicitly lutein, slows the progression of the disease in advanced stages. The induction of vascular endothelial growth factor (VEGF) inhibitors in the treatment of neovascular AMD, often combined with other modalities, has shown an immensely favorable prognosis. Research to integrate gene therapy and regenerative techniques using stem cells is underway to further mitigate AMD-associated morbidity. It is imperative to establish screening and therapeutic guidelines for AMD to curtail the future social and financial burden and improve the diminishing quality of life among the elderly.

Association between deficient levels of vitamin D and the occurrence of selected retinal diseases

“…[5] Noteworthy risk factors encompass smoking, nutritional elements, cardiovascular disorders and genetic markers. [11] However, the precise mechanisms behind AMD's development remain unclear. Recently, illness has been linked to various pathological factors, including oxidative stress and inflammation.…”

Immunogenetic and Environmental Factors in Age-Related Macular Disease

“…This process has an important role in the development of wet AMD. Smoking causes inflammation by decreasing concentration of complement factor H (CFH) in the blood and activating inflammatory mediators (e.g., complement C3) [ 90 , 91 , 92 , 93 , 94 , 95 ]. Environmental independent studies from Australia, Europe, and North America prove the role of smoking in the development of AMD [ 90 ].…”

“…There are thousands of chemicals in the cigarettes, which have harmful influences on the organism. Numerous substances increase the level of oxidative stress, which lead to lipid peroxidation [10,[90][91][92][93][94]. According to Velilla et al (2013) [90], smoking affects the occurrence of molecular and pathological changes, which very strongly affect the macula and decide on the incidence of AMD.…”

Nanoparticle-based optical interfaces for retinal neuromodulation: a review

“…Some of the most common causes of blindness are degenerative diseases of the outer retina, like age-related macular degeneration (AMD) and retinitis pigmentosa (RP). AMD is the leading cause of blindness in people aged 50 years and older in high-income countries ( Chaudhuri et al, 2023 ), while RP is the leading cause of visual disability and blindness in those younger than 60 years old, affecting over 1.5 million people worldwide ( Verbakel et al, 2018 ). Conventional retinal prostheses generally aim to bypass the photoreceptors and restore vision in blind patients by electrically stimulating the surviving inner retinal neurons with an electrode array.…”