Age-related maculopathy : linking aetiology and pathophysiological changes to the ischaemia hypothesis
Feigl, Beatrix (2008) Age-related maculopathy : linking aetiology and pathophysiological changes to the ischaemia hypothesis. Progress in Retinal and Eye Research, 28(1), pp. 63-86.
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Age-related maculopathy (ARM) has remained a challenging topic with respect to its aetiology, pathomechanisms, early detection and treatment since the late 19th century when it was first described as its own entity. ARM was previously considered an inflammatory disease, a degenerative disease, a tumor and as the result of choroidal hemodynamic disturbances and ischaemia. The latter processes have been repeatedly suggested to have a key role in its development and progression. In vivo experiments under hypoxic conditions could be models for the ischaemic deficits in ARM. Recent research has also linked ARM with gene polymorphisms. It is however unclear what triggers a person's gene susceptibility. In this manuscript, a linking hypothesis between aetiological factors including ischaemia and genetics and the development of early clinicopathological changes in ARM is proposed.
New clinical psychophysical and electrophysiological tests are introduced that can detect ARM at an early stage. Models of early ARM based upon hemodynamic, photoreceptor and post-receptoral deficits are described and the mechanisms by which ischaemia may be involved as a final common pathway are considered. In neovascular age-related macular degeneration (neovascular AMD), ischaemia is thought to promote release of vascular endothelial growth factor (VEGF) which induces chorioretinal neovascularisation. VEGF is critical in the maintenance of the healthy choriocapillaris. In the final section of the manuscript the documentation of the effect of new anti-VEGF treatments on retinal function in neovascular AMD is critically viewed.
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|Item Type:||Journal Article|
|Keywords:||Age-related maculopathy, Ischaemia, Hypoxia, Basal Laminar deposits, Basal linear deposits, Complement factor H, Electroretinography, VEGF, Ranibizumab, Bevacizumab|
|ISSN:||1873-1635 (online) 1350-9462 (print)|
|Subjects:||Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300) > Vision Science (111303)|
|Divisions:||Current > QUT Faculties and Divisions > Faculty of Health|
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Optometry & Vision Science
|Copyright Owner:||Copyright 2008 Elsevier Ltd.|
|Deposited On:||04 Feb 2010 07:18|
|Last Modified:||09 Mar 2012 03:48|
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