Original Title:
Ηλικιακή εκφύλιση της ωχράς κηλίδας: παθοφυσιολογικοί μηχανισμοί, παράγοντες κινδύνου, γονιδιακές συσχετίσεις και θεραπευτικές παρεμβάσεις στη νόσο
Summary:
Αge-related macular degeneration (AMD) is a disease that affects older people
and tends to increase its impact in the developed world. Μacula is responsible
for any of the central, sharp vision.
The first clinical sign of the disease is the presence of drusen whose number
and size increase progressively. Retinal pigment epithelium changes occur. In
dry AMD, the final outcome is geographic atrophy. In wet AMD choroidal
neovascularization, retinal pigment epithelium detachment, hemorrhages and
other disorders result in the formation of a disciform scar.
Pathogenetic mechanisms include apoptotic-cell death mechanisms, polymorphisms
of ARMS2, APOE and complement factors’ genes and more. Risk factors include
age, smoking, weight, the presence of vitreoretinal adhesions, etc.
For the treatment of dry AMD oral supplementation (Zn, Cu, vit.E, vit.C, EPA /
DHA, lutein, zeaxanthin, beta-carotene), food and lifestyle modification,
modulators-inhibitors of the visual cycle (Fenretinide,ACU-4429) and inhibitors
of complement activation (POT-4,Eculizumab) are recommended.
The treatment of wet AMD includes intravitreal injections of anti-VEGF agents
(Pegaptanib, Ranibizumab, Bevacizumab), intravitreal depots of corticosteroids,
VEGF-Trap injections, Epimacular Brachytherapy and Photodynamic therapy (PDT).
Keywords:
age, degeneration, macula, risk, therapy
