Do blue light filters confer protection against age-related macular degeneration?
Do blue light filters confer protection against age-related macular degeneration?
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DOI：
10.1016/j.preteyeres.2004.05.001
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发表时间：
2004-09-01
影响因子：
17.8
通讯作者：
Sliney, DH
中科院分区：
文献类型：
--
作者：
Margrain, TH;Boulton, M;Sliney, DH
视网膜相关性黄斑变性（AMD）是发达国家的主要健康问题，约占所有盲人登记的一半。目前的治疗方案不适合大多数患者，因此，确定可为疾病预防方案提供信息的可改变的风险因素是一个优先事项。这篇综述评估了长期以来的信念，即蓝光暴露在AMD的发病机制中发挥了作用。实验室证据表明，光化学反应中的富氧环境的外层视网膜导致细胞毒性活性氧（ROS）的释放。这些ROS引起氧化应激，已知其有助于AMD的发展。可能参与AMD发病机制的确切染色孔尚不清楚，但老年色素脂褐素是一个可能的候选者。其需氧光反应性和对抗氧化活性的不利影响以及随时间的逐渐积累表明，尽管晶状体透镜的吸收特征发生变化，但其体内光毒性仍随着年龄的增长而增加。来自动物研究的证据证实了蓝光的破坏潜力，但结果并不直接适用于人类黄斑变性。对人类黄斑色素密度和白内障手术后AMD进展风险的研究进一步支持了蓝光暴露在AMD发病机制中起作用的假设，但流行病学证据是不明确的。总的来说，证据表明但尚未证实蓝光是AMD的风险因素。考虑到这种疾病的社会经济影响以及迫切需要确定可改变的风险因素，未来的工作应包括大规模临床试验，以评估蓝色阻断过滤器对AMD进展率的影响。(C)2004爱思唯尔有限公司保留所有权利。
Age-related macular degeneration (AMD) is a major health problem in the developed world accounting for approximately half of all blind registrations. Current treatment options are unsuitable for the majority of patients and therefore the identification of modifiable risk factors that may inform disease prevention programmes is a priority. This review evaluates the long-held belief that blue light exposure has a role in the pathogenesis of AMD. Laboratory evidence has demonstrated that photochemical reactions in the oxygen-rich environment of the outer retina lead to the liberation of cytotoxic reactive oxygen species (ROS). These ROS cause oxidative stress which is known to contribute to the development of AMD. The precise chromopore that may be involved in the pathogenesis of AMD is unclear but the age pigment lipofuscin is a likely candidate. Its aerobic photoreactivity and adverse effects on antioxidant activity combined with its gradual accumulation over time suggests that its in vivo phototoxicity increases with age despite changes in the absorption characteristics of the crystalline lens. Evidence from animal studies confirms blue light's damaging potential but the results are not directly applicable to macular degeneration in humans. Studies of human macular pigment density and the risk of AMD progression following cataract surgery lend further weight to the hypothesis that blue light exposure has a role in the pathogenesis of AMD but the epidemiological evidence is equivocal. On balance the evidences suggests but does not yet confirm that blue light is a risk factor for AMD. Given the socio-economic impact of this disease and urgent need to identify modifiable risk factors, future work should include a large-scale clinical trial to evaluate the effect of blue blocking filters on AMD progression rates. (C) 2004 Elsevier Ltd. All rights reserved.