年龄相关性黄斑变性发病机制的研究进展

Recent advance of the study on pathogenesis of age-related macular degeneration

年龄相关性黄斑变性(age-related macular degeneration,AMD)是引起中老年严重视力丧失最主要的原因。尽管进行了大量的基础和临床研究,其发病机制仍不清楚,大多数学者认为这是一种多因素疾病。除了与年龄有极强的相关性,代谢、功能、基因和环境等因素均影响其发病,在黄斑区,这些作用因素引起包括脉络膜毛细血管、Bruch膜、视网膜色素上皮细胞和光感受器等组织发生病变,从而引起不同程度AMD的发病和结局。除了遗传倾向外,氧化应激导致的脂褐素生成、drusen的形成、局部炎症和新生血管形成都是其发病原因。本文就今年来AMD发病的主要分子和细胞机制所取得的进展进行综述。

Age-related macular degeneration （AMD） is a disease leading to severe visual loss and legal blindness in the elderly population. Its pathogenesis, likely multifactorial, involving a complex interaction of metabolic, functional, genetic and environmental factors, remains poorly understood. Although major abnormalities are seen in four functionally interrelated tissues, i. e., photoreceptors, retinal pigment epithelium （ RPE ）, Bruch＇ s membrane and choriocapillaries, the impairment of RPE cell functions is an early and crucial event in the molecular pathways leading to clinically relevant AMD changes. RPE progressively degenerate, which results in a progressive irreversible degeneration of photoreceptors. Four processes： lipofuscinogenesis, drusogenesis, inflammation and neovascularization, specifically contribute to the development of AMD. We briefly described major molecular and cellular events leading to AMD.