Marchesi Nicoletta, Capierri Martina, Pascale Alessia, Barbieri Annalisa
Department of Drug Sciences, Section of Pharmacology, University of Pavia, 27100 Pavia, Italy.
Int J Mol Sci. 2024 Dec 4;25(23):13053. doi: 10.3390/ijms252313053.
Age-related macular degeneration (AMD) is the most common cause of irreversible loss of central vision in elderly subjects, affecting men and women equally. It is a degenerative pathology that causes progressive damage to the macula, the central and most vital part of the retina. There are two forms of AMD depending on how the macula is damaged, dry AMD and wet or neovascular AMD. Dry AMD is the most common form; waste materials accumulate under the retina as old cells die, not being replaced. Wet AMD is less common, but can lead to vision loss much more quickly. Wet AMD is characterized by new abnormal blood vessels developing under the macula, where they do not normally grow. This frequently occurs in patients who already have dry AMD, as new blood vessels are developed to try to solve the problem. It is not known what causes AMD to develop; however, certain risk factors (i.e., age, smoking, genetic factors) can increase the risk of developing AMD. There are currently no treatments for dry AMD. There is evidence that not smoking, exercising regularly, eating nutritious food, and taking certain supplements can reduce the risk of acquiring AMD or slow its development. The main treatment for wet AMD is inhibitors of VEGF (vascular endothelial growth factor), a protein that stimulates the growth of new blood vessels. VEGF inhibitors can stop the growth of new blood vessels, preventing further damage to the macula and vision loss. In most patients, VEGF inhibitors can improve vision if macular degeneration is diagnosed early and treated accordingly. However, VEGF inhibitors cannot repair damage that has already occurred. Current AMD research is trying to find treatments for dry AMD and other options for wet AMD. This review provides a summary of the current evidence regarding the different treatments aimed at both forms of AMD with particular and greater attention to the dry form.
年龄相关性黄斑变性（AMD）是老年人群不可逆性中心视力丧失的最常见原因，对男性和女性的影响相同。它是一种退行性病变，会对黄斑（视网膜的中心且最重要的部分）造成渐进性损害。根据黄斑受损方式的不同，AMD有两种形式，干性AMD和湿性或新生血管性AMD。干性AMD是最常见的形式；随着旧细胞死亡，视网膜下会堆积废物，且这些废物无法得到替换。湿性AMD不太常见，但会更快导致视力丧失。湿性AMD的特征是黄斑下出现异常的新生血管，而这些血管在正常情况下不会生长。这种情况经常发生在已经患有干性AMD的患者身上，因为会形成新的血管来试图解决问题。目前尚不清楚AMD的发病原因；然而，某些风险因素（如年龄、吸烟、遗传因素）会增加患AMD的风险。目前干性AMD尚无治疗方法。有证据表明，不吸烟、定期锻炼、食用营养丰富的食物以及服用某些补充剂可以降低患AMD的风险或减缓其发展。湿性AMD的主要治疗方法是使用VEGF（血管内皮生长因子）抑制剂，VEGF是一种刺激新血管生长的蛋白质。VEGF抑制剂可以阻止新血管的生长，防止黄斑进一步受损和视力丧失。在大多数患者中，如果黄斑变性能早期诊断并得到相应治疗，VEGF抑制剂可以改善视力。然而，VEGF抑制剂无法修复已经发生的损伤。目前针对AMD的研究正在努力寻找干性AMD的治疗方法以及湿性AMD的其他治疗选择。这篇综述总结了目前针对两种形式AMD的不同治疗方法的现有证据，尤其更加关注干性AMD。
