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年龄相关性黄斑变性:一种视觉障碍和不可逆失明的指数级增长的迫在眉睫的威胁。

Age-Related Macular Degeneration: An Exponentially Emerging Imminent Threat of Visual Impairment and Irreversible Blindness.

作者信息

Chaudhuri Madhurima, Hassan Yusra, Bakka Vemana Pansy Prardhana Sinha, Bellary Pattanashetty Muktha S, Abdin Zain U, Siddiqui Humza F

机构信息

Department of Ophthalmology, Medical College and Hospital, Kolkata, IND.

Ophthalmology, University of Illinois at Chicago, Chicago, USA.

出版信息

Cureus. 2023 May 29;15(5):e39624. doi: 10.7759/cureus.39624. eCollection 2023 May.

Abstract

Age-related macular degeneration (AMD) is a significant cause of blindness globally. With the exponential rise in the aging population, AMD is the third leading cause of visual impairment worldwide. Neovascular AMD (nAMD; Wet AMD) and geographical atrophy (GA, late-stage dry AMD) are the advanced AMD accountable for substantial cases of visual deterioration among the elderly. Our review of the literature depicted that notable risk factors include cigarette smoking, nutritional elements, cardiovascular disorders, and genetic markers, including genes regulating complement, lipid, and angiogenic pathways. Some studies have suggested a relative decline in the proportion of AMD cases in the last two decades attributable to novel diagnostic and therapeutic modalities. Accurate diagnosis is the result of a combination of clinical examination and imaging techniques, including retinal photography, angiography, and optical coherence tomography. The incorporation of dietary antioxidant supplements, explicitly lutein, slows the progression of the disease in advanced stages. The induction of vascular endothelial growth factor (VEGF) inhibitors in the treatment of neovascular AMD, often combined with other modalities, has shown an immensely favorable prognosis. Research to integrate gene therapy and regenerative techniques using stem cells is underway to further mitigate AMD-associated morbidity. It is imperative to establish screening and therapeutic guidelines for AMD to curtail the future social and financial burden and improve the diminishing quality of life among the elderly.

摘要

年龄相关性黄斑变性(AMD)是全球失明的一个重要原因。随着老年人口呈指数级增长,AMD是全球视力损害的第三大主要原因。新生血管性AMD(nAMD;湿性AMD)和地图样萎缩(GA,晚期干性AMD)是导致老年人大量视力恶化病例的晚期AMD类型。我们对文献的综述表明,显著的风险因素包括吸烟、营养因素、心血管疾病以及遗传标记,包括调节补体、脂质和血管生成途径的基因。一些研究表明,由于新的诊断和治疗方式,在过去二十年中AMD病例的比例相对下降。准确的诊断是临床检查和成像技术相结合的结果,包括视网膜摄影、血管造影和光学相干断层扫描。膳食抗氧化剂补充剂,特别是叶黄素的摄入,可减缓疾病在晚期的进展。在新生血管性AMD治疗中使用血管内皮生长因子(VEGF)抑制剂,通常与其他方式联合使用,已显示出非常良好的预后。正在进行利用干细胞整合基因治疗和再生技术的研究,以进一步减轻与AMD相关的发病率。必须为AMD制定筛查和治疗指南,以减轻未来的社会和经济负担,并改善老年人不断下降的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dcd/10300666/2d13551546b9/cureus-0015-00000039624-i01.jpg

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