Age-related macular degeneration (AMD) – disease of ageing society
Journal Title: Postępy Nauk Medycznych - Year 2013, Vol 26, Issue 12
Abstract
Age-related macular degeneration is the leading cause of blindness in elderly population. About 25 millions of individuals are affected with AMD. The most consistent risk factors associated with this ocular condition are increasing age, genetic predisposition and cigarette smoking. Lesions develop within the outer retina and adjacent choroidal capillaries, starting in pigment epithelium cells. The pathogenesis of AMD is multifactorial and remains unclear. Probably aging processes are superimposed by increased oxidative stress, excessive activation of complement and chronic inflammation in subretinal space. Genetic factors, particularly genes encoding complement regulators and components seem to play an important role in pathogenesis of AMD. Environmental factors such as low intake of diet antioxidants and tobacco smoking contribute to risk. Oxidative stress in pigment epithelium is hypothesized to be a major contributor to the development of AMD. Intense oxidative metabolism within outer retina, constant exposure to light, presence of photosensitizers and polyunsaturated fatty provide a permissive environment for oxidative damage. Carboxyethylpyrrole (CEP) adducts generated from the oxidative damage of docosahexaenoic acid (DHA) may play a role in initiation of AMD. CEP adducts are antigenic and stimulate immune system which leads to complement-mediated disease during aging. This CEP adduct might be the inflammatory signal from the outer retina that initiates AMD. This paper present the current views on the risk factors and pathogenesis of AMD.
Authors and Affiliations
Irmina Jankowska-Lech, Iwona Grabska-Liberek, Aldona Krzyżewska-Niedziałek, Marta Pietruszyńska
Keywords
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