Age-related macular degeneration (AMD) is the leading cause of visual impairment and blindness in the USA. Although the treatment of AMD has evolved to include laser photocoagulation, photodynamic therapy, surgical macular translocation and antiangiogenesis agents, treatment options for advanced AMD are limited. Furthermore, the dry form of AMD, albeit less devastating than the wet form, has even fewer viable treatment options. This review summarizes the various biomarkers of AMD and analyzes whether or not they may one day be exploited to determine risks of disease onset, measure progression of disease or even assess the effects of treatment of AMD. Potential biomarkers are important to identify since some might be utilized to reflect the disease state of a particular patient and to individualize therapy. Although studies have yielded promising results for nutrient and inflammatory biomarkers, these results have been inconsistent. At present, the best available markers of AMD risk are single nucleotide polymorphisms (SNPs). SNPs in complement factor H (CFH) and PLEKHA1/ARMS2/HtrA1 capture a substantial fraction of AMD risk and permit the identification of individuals at high risk of developing AMD.
Keywordsage-related macular degeneration; biomarker; genetic marker; inflammation; nutrient; risk assessment; single nucleotide polymorphism; target molecules † Author for correspondence 10/10N103, 10 Center Drive, Bethesda, MD 20892-1857
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NIH-PA Author ManuscriptAge-related macular degeneration (AMD) is a disease characterized by chronic and progressive degeneration of photoreceptors, the underlying retinal pigment epithelium (RPE), Bruch's membrane and, possibly, the choriocapillaries in the macula. Clinical and pathological features of AMD include thickened Bruch's membrane, drusen formation, pathological changes of the RPE, photoreceptor atrophy, choroidal neovascularization (CNV) and/or fibroglial tissue in the macula. These alterations result in the loss of central visual acuity [1].AMD is the leading cause of visual impairment and blindness in the USA [2]. To date, there is no proven treatment of advanced or early AMD. Low-intensity laser treatment in patients with bilateral large drusen has not been shown to be effective in the prevention of vision loss [3]. Medical therapy of AMD has focused mainly on treatments of CNV. Of these treatments, most target vascular endothelial growth factor (VEGF), which is recognized as the major angiogenic factor.The etiology of AMD remains elusive. AMD pathogenesis involves environmental factors and varying susceptibilities to these external factors based upon different genetic backgrounds [4]. Many efforts have been made to identify genetic markers or biological features that can be used to predict the risk of disease onset and measure the progression of AMD or the effects of treatment. Given that serum and tissue levels of select nutrients, such as xanthophylls, have shown to be associated with a decreased risk of AMD...