Age-related macular degeneration

Summary Age-related macular degeneration is the leading cause of blindness in elderly populations of European descent. The most consistent risk factors associated with this ocular condition are increasing age and cigarette smoking. Genetic investigations have shown that complement factor H, a regula...

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Bibliographic Details
Published in:The Lancet (British edition) 2008-11, Vol.372 (9652), p.1835-1845
Main Authors: Coleman, Hanna R, MD, Chan, Chi-Chao, MD, Ferris, Frederick L, MD, Chew, Emily Y, Dr
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aging - physiology
Antibodies, Monoclonal - therapeutic use
Antibodies, Monoclonal, Humanized
Antioxidants - therapeutic use
Cigarettes
Eyes & eyesight
Female
Humans
Industrialized nations
Internal Medicine
Laser Coagulation - methods
Macular degeneration
Macular Degeneration - physiopathology
Macular Degeneration - prevention & control
Macular Degeneration - therapy
Male
Middle Aged
Monoclonal antibodies
Older people
Oxidative stress
Photosensitizing Agents - therapeutic use
Porphyrins - therapeutic use
Prevalence
Ranibizumab
Retina
Risk Factors
Smoking
Smoking - adverse effects
Vascular Endothelial Growth Factor A - antagonists & inhibitors
Verteporfin
Vitamins
Zinc - therapeutic use
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Summary:Summary Age-related macular degeneration is the leading cause of blindness in elderly populations of European descent. The most consistent risk factors associated with this ocular condition are increasing age and cigarette smoking. Genetic investigations have shown that complement factor H, a regulator of the alternative complement pathway, and LOC387715/HtrA1 are the most consistent genetic risk factors for age-related macular degeneration. Although the pathogenesis of this disease is unknown, oxidative stress might have an important role. Treatment with antioxidant vitamins and zinc can reduce the risk of developing advanced age-related macular degeneration by about a quarter in those at least at moderate risk. Intravitreal injections of ranibizumab, a monoclonal antibody that inhibits all forms of vascular endothelial growth factor, have been shown to stabilise loss of vision and, in some cases, improve vision in individuals with neovascular age-related macular degeneration. These findings, combined with assessments of possible environmental and genetic interactions and new approaches to modulate inflammatory pathways, will hopefully further expand our ability to understand and treat age-related macular degeneration.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(08)61759-6