Age-Related Maculopathy: a biochemical and immunohistochemical study

Age-related maculopathy (ARM) is an age-related degenerative disorder of the central part of the retina, the macula lutea (yellow spot). Essentially, ARM is a clinical diagnosis based on funduscopical changes. It is customary nowadays to call the late stages of ARM, geographic atrophy and neovascular (disciform) macular degeneration, age-related macular degeneration (AMD)(Bird, et ai., 1995). These late stages result in severe and irreversible visual impairment and tend to progress to the center of the macula (the fovea), where visual acuity is affected most. Because AMD is usually a bilateral disorder, affected people loose their ability to read, drive, and watch television (Macular-photocoagulation-study-group, 1993). The prevalence of AMD is 1-7% in people over 60, up to 14% over age 85. Obviously, the number of people affected by AMD will enlarge, because of the increasing age of the population (Ferris, 1983; Klein, el ai., 1992; Leibowitz, el ai., 1980; Vinding, 1989; Vingerling, et ai., 1995c). In fact, AMD is the mosl common cause of blindness in the elderly in the weslern world and it is estimated that 640.000 people in the USA aged 75 years or older have signs of AMD (Klein, et ai., 1992), while in The Netherlands 57.000 persons suffer from AMD in at least one eye (Vingerling, et ai., 1995d). Although this disease has been known for more than a century (Haab, 1888), knowledge on the patllOgenesis of the affliction is still incomplete. Some risk-factors for ARM have been found in epidemiologic studies. Current smokers have a three times increased risk to develop this disease (Vingerling, et ai., 1995b), and cardiovascular diseases and early-menopause are reported to be risk-factors as well (Vingerling, et ai., 1995a; Vingerling, et aI., 1995e). There is still no adequate therapy for the majority of people disabled by AMD. Therefore, it is necessary to intensify the research on ARM and AMD in order to understand the pathogenesis of this disease. This knowledge may eventually lead to an adequate therapy or to preventive measures for this severely invalidating disease.

• View at Worldcat

Free Full Text ( Final Version , 3mb )