湿性年龄相关性黄斑变性发病机制及治疗

Pathogenesis and treatment of wet age-related macular degeneration

湿性年龄相关性黄斑变性(AMD)是导致老年人视力受损甚至失明的重要原因,以黄斑区新生血管为主要病理特征,其发病与年龄、环境、遗传、氧化应激、脂质代谢、免疫机制等多因素相关。血管内皮生长因子(VEGF)已被证实是导致湿性AMD的重要因子。因此,抗VEGF药物是湿性AMD治疗领域中里程碑性的进展,但该治疗方法仍有诸多不足,如需要多次注射、部分患者对治疗应答欠佳甚至无应答、可能发生进行性纤维化等并发症。目前,许多新药正在被开发用来解决现有抗VEGF药物治疗的弊端。通过检索国内外相关文献及报道,我们对湿性AMD的分型、发病机制、治疗等的研究进展进行述评。

Wet age-related macular degeneration(wet AMD)is the main cause of visual impairment and even blindness in the elderly,with the primary pathological symptom of macular neovascularization.The pathogenesis of wet AMD is related to many factors,including age,environment,genetics,oxidative stress,lipid metabolism,and immunological mechanisms.Vascular endothelial growth factor(VEGF)has been proven to be a key factor that contributes to wet AMD.Therefore,the development of anti-VEGF drugs served as a milestone in treating wet AMD.However,current anti-VEGF drugs still have drawbacks,such as the need for multiple injections,lack of efficiency or even unresponsiveness in certain patients,and possible complications like progressive fibrosis.Currently,many new drugs are being developed to overcome the shortcomings of the existing anti-VEGF therapies.By searching relevant literature and reports,in this work we summarized and commented on the recent advancements in the classification,pathogenesis,and treatment of wet AMD.