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年龄相关性黄斑变性(AMD)的机制性见解:解剖学、流行病学、遗传学、发病机制、预防、意义及加速AMD管理的治疗策略

Mechanistic Insight into Age-Related Macular Degeneration (AMD): Anatomy, Epidemiology, Genetics, Pathogenesis, Prevention, Implications, and Treatment Strategies to Pace AMD Management.

作者信息

Amini Mohammad Amin, Karbasi Ashkan, Vahabirad Mohammad, Khanaghaei Masoud, Alizamir Aida

机构信息

Department of Clinical Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

Department of Laboratory Sciences, Sirjan Faculty of Medical Sciences, Sirjan, Iran.

出版信息

Chonnam Med J. 2023 Sep;59(3):143-159. doi: 10.4068/cmj.2023.59.3.143. Epub 2023 Sep 25.

Abstract

One of the most complicated eye disorders is age-related macular degeneration (AMD) which is the leading cause of irremediable blindness all over the world in the elderly. AMD is classified as early stage to late stage (advanced AMD), in which this stage is divided into the exudative or neovascular form (wet AMD) and the nonexudative or atrophic form (dry AMD). Clinically, AMD primarily influences the central area of retina known as the macula. Importantly, the wet form is generally associated with more severe vision loss. AMD has a systemic component, where many factors, like aging, genetic, environment, autoimmune and non-autoimmune disorders are associated with this disease. Additionally, healthy lifestyles, regular exercise, maintaining a normal lipid profile and weight are crucial to decreasing the risk of AMD. Furthermore, therapeutic strategies for limiting AMD should encompass a variety of factors to avoid and improve drug interventions, and also need to take into account personalized genetic information. In conclusion, with the development of technology and research progress, visual impairment and legal blindness from AMD have been substantially reduced in incidence. This review article is focused on identifying and developing the knowledge about the association between genetics, and etiology with AMD. We hope that this review will encourage researchers and lecturers, open new discussions, and contribute to a better understanding of AMD that improves patients' visual acuity, and upgrades the quality of life of AMD patients.

摘要

年龄相关性黄斑变性(AMD)是最复杂的眼部疾病之一,是全球老年人不可治愈失明的主要原因。AMD分为早期至晚期(晚期AMD),其中该阶段又分为渗出性或新生血管性形式(湿性AMD)和非渗出性或萎缩性形式(干性AMD)。临床上,AMD主要影响视网膜的中央区域,即黄斑。重要的是,湿性形式通常与更严重的视力丧失有关。AMD有一个全身性因素,许多因素,如衰老、遗传、环境、自身免疫和非自身免疫性疾病都与这种疾病有关。此外,健康的生活方式、定期锻炼、保持正常的血脂水平和体重对于降低AMD风险至关重要。此外,限制AMD的治疗策略应包括多种因素,以避免和改进药物干预,还需要考虑个性化的遗传信息。总之,随着技术的发展和研究的进步,AMD导致的视力损害和法定失明的发病率已大幅降低。这篇综述文章的重点是识别和发展关于遗传学以及AMD病因之间关联的知识。我们希望这篇综述将鼓励研究人员和讲师,开启新的讨论,并有助于更好地理解AMD,从而提高患者的视力,并提升AMD患者的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54f6/10570864/f176169340af/cmj-59-143-g001.jpg

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