Recent developments in age-related macular degeneration: a review

Abstract

Background: Visual impairment in elderly people is a considerable health problem that significantly affects quality of life of millions worldwide. The magnitude of this issue is becoming more evident with an aging population and an increasing number of older individuals. Objective: The objective of this article was to review the clinical and pathological aspects of age-related macular degeneration (AMD), diagnostic tools, and therapeutic modalities presently available or underway for both atrophic and wet forms of the disease. Methods: An online review of the PubMed database was performed, searching for the key words. The search was limited to articles published since 1980 to date. Results: Several risk factors have been linked to AMD, such as age (.60 years), lifestyle (smoking and diet), and family history. Although the pathogenesis of AMD remains unclear, genetic factors have been implicated in the condition. Treatment for atrophic AMD is mainly close observation, coupled with nutritional supplements such as zinc and antioxidants, whereas treatment of wet AMD is based on targeting choroidal neovascular membranes. Conclusion: Identification of modifiable risk factors would improve the possibilities of preventing the progression of AMD. The role of anti-vascular endothelial growth factor (anti-VEGF) agents has transformed the therapeutic approach of the potentially blinding disease "wet AMD" into a more favorable outcome.

Optometry Australia's chairside reference for the diagnosis and management of age‐related macular degeneration

“…12 Observation of pigmentary abnormalities also means a higher risk of developing late stage disease. [34][35][36] In early AMD (medium drusen only), people have a 3.1 per cent chance of progressing to late AMD within five years. 35 However, once a person has large drusen and pigmentary abnormalities in both eyes (intermediate AMD), this risk increases to around 47.3 per cent.…”

Prioritising research into age‐related macular degeneration

“…3 About half of people with late AMD show areas of damage to the retina (geographic atrophy), which tends to worsen over years or decades. [3][4][5] The remainder have 'wet' AMD, when blood vessels proliferate behind the retina (choroidal neovascularisation), which typically progresses over weeks or months. [3][4][5] As AMD progresses, patients typically experience distorted vision when reading, driving or watching television.…”

“…[3][4][5] The remainder have 'wet' AMD, when blood vessels proliferate behind the retina (choroidal neovascularisation), which typically progresses over weeks or months. [3][4][5] As AMD progresses, patients typically experience distorted vision when reading, driving or watching television. They may have problems recognising faces and report a dark or grey patch (scotoma) in their central vision (see Figure 1).…”

“…And the RPE becomes less able to completely digest the outer segments of the photoreceptors, forming yellow, plaque-like, extracellular deposits called drusen between the RPE and the Bruch's membrane. 5 Small (<63μm diameter; also called hard) drusen are almost inevitable with normal ageing. However, medium-sized (63-125μm) or larger drusen, or macular hyper-or hypopigmentation, or both, characterise AMD.…”

Nicotinamide as a treatment option of Age-Related Macular Degeneration

“…The deposits are composed of lipids and proteins including many complement proteins, indicating the involvement of the complement system in the degenerative process and chronic in lammation [2]. So far there is no treatment for the dry form of AMD, except nutritional supplementation with antioxidants and vitamins [3]. Combined with a prolonged lifetime expectation in developed countries, AMD is developing to a social and economic burden.…”