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Today and Future of Age-Related Macular Degeneration

DOI: 10.5402/2012/480212

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Abstract:

Age-related macular degeneration (AMD) is the leading cause of blindness in people over 50 in developed countries. Understanding of the pathologic process, genetic mechanisms, and risk factors of this disease has the benefit of seeking newer and more effective treatment options. Current clinical therapy for AMD shows a dramatic change from a decade ago. Anti-VEGF drug therapy is regarded as the more effective treatment for neovascular AMD now, especially combining PDT therapy. In the future, the genetic and biochemical therapies may be the promising treatments for AMD. This paper will focus on the progress of pathology, candidate genes of AMD, risk factors, and the existing drugs or surgical therapies available, in order to present some new directions of care with the prospect of improved vision in many patients suffered from AMD. 1. Introduction Age-related macular degeneration (AMD) remains one of the most severe and profound disabilities encountered in medicine, particularly due to the loss of the central vision and the high economic burden it places on patients and societies. AMD is regarded as the most primary cause of blindness, particularly irreversible blindness [1]. The world Health Organization (WHO) summarised the most recent reports which the visual impairment was caused by many common ocular diseases, it was not difficult to find that AMD is the most common cause of blindness. AMD has resulted in the physical and mental health problems of a number of the geriatric population and their families tremendously. Recent years, it was not only high morbidity of AMD in western nations but also progressive incidence in eastern Asia areas, thus, continued research will be critically needed. There were about over one hundred years for scientists to study AMD. Hutchison and Tay published an article named “symmetrical central choroidoretinal disease occurring in senile persons” in 1875. This may be the earliest medical literature about AMD that we can find. We reviewed the basic research towards AMD during about decade. There were three aspects should be summarized, including morphology, molecular biology, and genomics. AMD resulted from many dangerous factors, including genes and environment. With advancing age, some changes occurred in the retina, including alterations in retinal pigment epithelium (RPE) cellular size and shape, thickening of Bruch’s membrane, thickening of the internal limiting membrane, and a decrease in retinal neuronal elements [2]. From a histopathologic standpoint, the initial morphological changes impacted on the photoreceptors

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