Macular degeneration

Macular degeneration

macula-with-macular-degeneration

Facts about Macular degeneration

  • Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly.
  • Its is a progressive neurodegenerative disease that affects approximately 8.7% of elderly people worldwide (>55 years old).
  • There are two types of AMD: dry AMD and wet AMD.
  • According to the latest predictions released by the United Nations, the number of people aged over 60 will triple from 606 million worldwide in 2000 to nearly 2 billion by 2050.

Research scope in Macular degeneration

  • Application of curcumin may be a novel strategy to protect against age-related change in AMD.
  • rAAV.sFlt-1 gene therapy may prove to be a potential adjunct or alternative to conventional intravitreal injection for patients with wet AMD by providing extended delivery of a naturally occurring antiangiogenic protein.
  • Study suggests a protective effect of olive oil consumption for late AMD in this elderly community-dwelling population. Characterization of the mediating nutrients deserves further research.

Treatment for Macular degeneration

  • Curcumin a potent therapeutic drug candidate for inflammatory and degenerative retinal and eye diseases.
  • Ranibizumab 0·3 or 0·5 mg monthly treatment was more effective for neovascular AMD than non-anti-VEGF treatments but is no better than bevacizumab.
  • Monthly injected bevacizumab was the most cost-effective treatment and monthly ranibizumab the least effective.

Prevention of Macular degeneration

  • Studies have provided evidence that vitamin D may protect against AMD.
  • Consuming diets that provide low-dietary glycemic index (dGI) and higher intakes of these nutrients were associated with the greatest reduction in risk for prevalent drusen and advanced AMD
  • Aerobic exercise is neuroprotective for retinal degeneration
  • There is a strong protective effects of the variant alleles of four SNPs in CFB/C2 gene (rs9332739, rs547154, rs4151667, and rs641153) against AMD.

Risk factors for Macular degeneration

  • High 25OHD concentrations may be protective against AMD, and that 25OHD concentrations below 50nmol/L are associated with late AMD.
  • Diabetes mellitus is a strong risk factor of age-related macular degeneration.
  • Meta-analysis has revealed suggestive evidence for TLR3 rs3775291 as an associated marker for AMD in Caucasians but not in Asians.
  • Smoking, previous cataract surgery and a family history of AMD are consistent risk factors for AMD. 
  • AMD is associated with elevated tHcy levels and decreased vitamin B12 levels.
  • Modifiable risk factors such as smoking and hyperlipidemia are associated with the prevalence of early AMD
  • There is a statistically significant association between aspirin use and the risk of AMD.
  • A higher intake of vitamin A increased the risk of macular drusen >63 μm in subjects with CFHY402H. The study supports that vitamin A may be a risk factor for early AMD.

Systematic reviews

  • Dietary ω-3 Fatty Acid and Fish Intake in the Primary Prevention of Age-Related Macular Degeneration…more
  • Aspirin and age-related macular degeneration: positives versus negatives..more
  • Relationship between SERPING1 rs2511989 polymorphism and age-related macular degeneration risk: A meta-analysis…more
  • Guidelines for the Management of Wet Age-Related Macular Degeneration: Recommendations from a Panel of Greek Experts…more

References

Risk scope

  • Drug Des Devel Ther. 2015 Sep 25;9:5337-44
  • Asia Pac J Ophthalmol (Phila). 2016 Jul-Aug;5(4):300-3
  • PLoS One. 2016 Jul 28;11(7):e0160240. doi: 10.1371/journal.pone.0160240. eCollection 2016

Risk factors

  • Maturitas. 2016 Jun;88:101-12
  • PLoS One. 2014 Sep 19;9(9):e108196. doi: 10.1371/journal.pone.0108196. eCollection 2014
  • Sci Rep. 2016 Jan 22;6:19718
  • BMC Ophthalmol. 2010 Dec 13;10:31. doi: 10.1186/1471-2415-10-31
  • Sci Rep. 2015 Jul 21;5:10585. doi: 10.1038/srep10585
  • J Korean Med Sci. 2012 May; 27(5): 537–541
  • J Clin Pharm Ther. 2015 Apr;40(2):144-54
  • Acta Ophthalmol. 2016 Aug 8. doi: 10.1111/aos.13198. [Epub ahead of print]

Prevention

  • Arch Ophthalmol. 2007 May;125(5):661-9
  • Ophthalmology. 2009 May;116(5):939-46
  • J Neurosci. 2014 Feb 12; 34(7): 2406–2412
  • Curr Eye Res. 2012 Apr;37(4):259-71

Treatment

  • Mol Nutr Food Res. 2013 Sep;57(9):1557-68
  • J Clin Pharm Ther. 2014 Jun;39(3):234-9
  • Acta Ophthalmol. 2016 Aug 2. doi: 10.1111/aos.13185. [Epub ahead of print]

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