Damico Francisco Max, Gasparin Fabio, Scolari Mariana Ramos, Pedral Lycia Sampaio, Takahashi Beatriz Sayuri
Medical School, University of São Paulo, Brazil.
Arq Bras Oftalmol. 2012 Jan-Feb;75(1):71-6. doi: 10.1590/s0004-27492012000100016.
Emerging treatments for dry age-related macular degeneration (AMD) and geographic atrophy focus on two strategies that target components involved in physiopathological pathways: prevention of photoreceptors and retinal pigment epithelium loss (neuroprotection induction, oxidative damage prevention, and visual cycle modification) and suppression of inflammation. Neuroprotective drugs, such as ciliary neurotrophic factor, brimonidine tartrate, tandospirone, and anti-amyloid β antibodies, aim to prevent apoptosis of retinal cells. Oxidative stress and depletion of essential micronutrients are targeted by the Age-Related Eye Disease Study (AREDS) formulation. Visual cycle modulators reduce the activity of the photoreceptors and retinal accumulation of toxic fluorophores and lipofuscin. Eyes with dry age-related macular degeneration present chronic inflammation and potential treatments include corticosteroid and complement inhibition. We review the current concepts and rationale of dry age-related macular degeneration treatment that will most likely include a combination of drugs targeting different pathways involved in the development and progression of age-related macular degeneration.
针对干性年龄相关性黄斑变性（AMD）和地图样萎缩的新兴治疗方法聚焦于两种策略，即针对生理病理途径中相关成分的策略：预防光感受器和视网膜色素上皮细胞丢失（诱导神经保护、预防氧化损伤以及调节视觉循环）和抑制炎症。神经保护药物，如睫状神经营养因子、酒石酸溴莫尼定、坦度螺酮和抗淀粉样β抗体，旨在预防视网膜细胞凋亡。年龄相关性眼病研究（AREDS）配方针对氧化应激和必需微量营养素的消耗。视觉循环调节剂可降低光感受器的活性以及有毒荧光团和脂褐素在视网膜的积累。干性年龄相关性黄斑变性的眼睛存在慢性炎症，潜在治疗方法包括皮质类固醇和补体抑制。我们综述了干性年龄相关性黄斑变性治疗的当前概念和基本原理，其很可能包括联合使用针对年龄相关性黄斑变性发生和发展中不同途径的药物。
