Current therapeutic developments in atrophic age-related macular degeneration.
Current therapeutic developments in atrophic age-related macular degeneration.
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DOI：
10.1136/bjophthalmol-2015-306972
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发表时间：
2016-01
期刊：
影响因子：
--
通讯作者：
Wang S
中科院分区：
文献类型：
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作者：
Hanus J;Zhao F;Wang S
视网膜相关性黄斑变性（AMD）是一种中央视网膜的退行性疾病，是老年人不可逆失明的主要原因。干性AMD的晚期形式（也称为地图状萎缩（GA）或萎缩性AMD）的潜在机制仍不清楚。因此，没有治愈可用于干性AMD或GA。目前唯一可用的预防选择是年龄相关性眼病研究（AREDS）制剂，已被证明可以减缓干性AMD的进展。本文就干性AMD和GA的治疗进展作一综述。基于对这种疾病的新认识和最近的技术突破，许多正在进行的临床试验的目标是满足治愈AMD的需求。正在开发针对该疾病的关键特征的治疗剂，包括抑制补体途径和其他炎症途径，减少氧化应激和保护视网膜色素上皮（RPE）细胞，抑制脂褐素和视觉周期，从干细胞再生RPE细胞和恢复脉络膜血流。其中一些治疗选择，特别是基于干细胞的治疗，有很大的希望，这给这种毁灭性的致盲疾病带来了很大的希望。
Age-related macular degeneration (AMD), a degenerative disorder of the central retina, is the leading cause of irreversible blindness in the elderly. The underlying mechanism of the advanced form of dry AMD, also named geographic atrophy (GA) or atrophic AMD, remains unclear. Consequently, no cure is available for dry AMD or GA. The only prevention option currently available is the Age Related Eye Disease Study (AREDS) formulation which has been demonstrated to slow down the progression of dry AMD. This review summarizes recent advances in therapy for dry AMD and GA. Building on the new understanding of the disease and recent technological breakthroughs, numerous ongoing clinical trials have the goal of meeting the need to cure AMD. Therapeutic agents are being developed to target the key features of the disease, including inhibiting the complement pathway and other inflammatory pathways, reducing oxidative stress and protecting retinal pigment epithelial (RPE) cells, inhibiting lipofuscin and visual cycle, regenerating RPE cells from stem cells and restoring choroidal blood flow. Some of these therapeutic options, especially the stem-cell based therapy, hold great promise, which brings great hope for this devastating blinding disease.