Changes in choriocapillaris and retinal pigment epithelium in age-related macular degeneration.
Changes in choriocapillaris and retinal pigment epithelium in age-related macular degeneration.
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发表时间：
1999-11
期刊：
影响因子：
2.2
通讯作者：
G. Lutty;J. Grunwald;A. Majji;M. Uyama;S. Yoneya
中科院分区：
文献类型：
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作者：
G. Lutty;J. Grunwald;A. Majji;M. Uyama;S. Yoneya
视网膜色素上皮细胞（RPE）和绒毛膜位于布鲁赫膜的两侧，控制着视网膜内外的转运。在年龄相关性黄斑变性（AMD）中，它们也可能导致Bruch膜内和膜上的物质沉积以及脉络膜新生血管（CNV）的形成或消退。吲哚菁绿（ICG）血管造影可以显示脉络膜血管和CNV。在年龄超过50岁的受试者中，ICG填充绒毛膜毛细血管延迟，并且在AMD受试者的黄斑中观察到低荧光区域，通常与CNV相关。黄斑处脉络膜毛细血管的激光多普勒血流测量显示，年龄大于46岁的受试者脉络膜血流量和体积减少，AMD患者的脉络膜血流量和体积进一步减少。通过培养碱性磷酸酶活性组织，将其平埋在透明聚合物中并切片，可以在两个维度上对人绒毛膜进行组织学研究。使用该技术，发现绒毛膜脱落与糖尿病患者布鲁氏膜物质沉积有关。当RPE从Bruch膜上移除时，绒毛膜变性；一种酪氨酸激酶抑制剂染料木黄酮可以阻断绒毛膜的再生。最后，在动物模型中，RPE细胞可能产生刺激CNV形成和消退的物质。这些研究表明，AMD患者的绒毛毛细血管流动可能减少，而这种绒毛毛细血管的减少可能与作为AMD标志的布鲁氏膜沉积有关。此外，RPE可刺激CNV的形成和消退，RPE的丧失可导致绒毛膜毛细血管的丧失。
Retinal pigment epithelial cells (RPE) and the choriocapillaris are on opposite sides of Bruch's membrane and control transport in and out of the retina. In age-related macular degeneration (AMD), they may also be responsible for deposition of material in and on Bruch's membrane and the formation or regression of choroidal neovascularization (CNV). Indocyanine green (ICG) angiography can be used to visualize the choroidal vasculature and CNV. Filling of the choriocapillaris with ICG was delayed in subjects older than 50 years of age, and areas of hypofluorescence were observed in maculas of AMD subjects, often associated with CNV. Laser Doppler flowmetry of the choriocapillaris in the macula demonstrated that choroidal blood flow and volume are reduced in subjects older than 46 years of age and further decreased in subjects with AMD. The human choriocapillaris can be histologically studied in two dimensions by incubating the tissue for alkaline phosphatase activity, flat-embedding it in transparent polymer and sectioning it. Using this technique, choriocapillaris dropout was found to be associated with deposition of material in Bruch's membrane in diabetic subjects. When RPE are removed from Bruch's membrane, the choriocapillaris degenerates; the regeneration of choriocapillaris can be blocked by Genistein, a tyrosine kinase inhibitor. Finally, RPE cells may produce substances that both stimulate the formation and regression of CNV in animal models. These studies suggest that there may be a reduction in choriocapillaris flow in AMD, and this loss of choriocapillaris can be associated with the Bruch's membrane deposits that are hallmarks of AMD. Furthermore, RPE may stimulate the formation and regression of CNV and RPE loss can result in loss of choriocapillaris.