Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Adv Exp Med Biol. 2019;1185:45-49. doi: 10.1007/978-3-030-27378-1_8.
The association between age-related macular degeneration (AMD) and biological rhythms has been insufficiently studied; however there are several reasons to believe that impairment in circadian rhythm may affect incidence and pathogenesis of AMD. The current understanding of AMD pathology is based on age-related, cumulative oxidative damage to the retinal pigmented epithelium (RPE) partially due to impaired clearance of phagocytosed photoreceptor outer segments. In higher vertebrates, phagocytosis of the outer segments is synchronized by circadian rhythms and occurs shortly after dawn, followed by lysosomal-mediated clearance. Aging has been shown to be associated with the changes in circadian rhythmicity of melatonin production, which can be a major factor contributing to the impaired balance between phagocytosis and clearance and increased levels of reactive oxygen species resulting in degenerative changes in the retina. This minireview summarizes studies linking AMD with melatonin production and discusses challenges and perspectives of this area of research.
年龄相关性黄斑变性（AMD）与生物节律之间的关联尚未得到充分研究；然而，有几个原因可以相信，昼夜节律的损害可能会影响 AMD 的发病机制。目前对 AMD 病理的理解是基于年龄相关性的、视网膜色素上皮（RPE）的累积性氧化损伤，部分原因是吞噬光感受器外节的清除能力受损。在高等脊椎动物中，吞噬作用被昼夜节律同步，发生在黎明后不久，随后是溶酶体介导的清除。已经表明，衰老与褪黑素产生的昼夜节律变化有关，这可能是导致吞噬作用和清除作用之间平衡受损以及活性氧水平增加的主要因素，从而导致视网膜退行性变化。这篇迷你综述总结了将 AMD 与褪黑素产生联系起来的研究，并讨论了这一研究领域的挑战和前景。
