Choroidal circulation in age related macular degeneration

描述（由申请人提供）：年龄相关性黄斑变性（AMD）是美国65岁以上人群失明的主要原因。大约10%的美国人会发展为AMD， 1%的人可能会患上晚期的渗出性AMD，导致严重的视力损害。这种疾病发生的基本机制尚不清楚。几份报告和我们实验室的一些初步数据表明AMD的脉络膜循环异常。这些报告非常有趣，因为这种循环提供了所有代谢物，并从视网膜外清除了所有废物。脉络膜循环异常可能在导致肾小球积聚的过程中起作用。这种疾病的特征。此外，脉络膜血管供应减少也可能导致外视网膜缺血和缺氧，这可能与脉络膜新生血管的发展有关，这是AMD的致盲并发症。这是一项延续提案，旨在扩大原先提议的研究范围。这些研究的主要目的是使用最先进的、无创的激光多普勒血流仪技术来研究黄斑变性患者脉络膜血流及其调节是否异常。此外，我们将研究更异常的脉络膜循环是否与发生脉络膜新生血管的风险更高以及AMD的更晚期和致盲阶段有关。从长远来看，更好地了解与AMD发展相关的机制可以帮助我们为这种毁灭性疾病设计新的治疗策略。此外，通过这项调查获得的知识也可以帮助识别有脉络膜新生血管形成风险的患者，从而使早期治疗成为可能。

DESCRIPTION (provided by applicant): Age-related macular degeneration (AMD) is the leading cause of blindness in people over the age of 65 in the United States. About 10% of the U.S. population will develop AMD and 1% may suffer from the more advanced, exudative form of the disease that leads to severe visual impairment. The basic mechanism involved in the development of this disease is not clearly understood. Several reports and some preliminary data from our laboratory have suggested abnormalities of the choroidal circulation in AMD. These reports are of great interest because this circulation supplies all metabolites and removes all waste products from the outer-retina. An abnormal choroidal circulation could have a role in the process that leads to the accumulation of drusen, one. of the hallmarks of this disease. In addition, a decreased choroidal vascular supply could also lead to ischemia and hypoxia of the outer retina and this could be associated with the development of choroidal neovascularization, a blinding complication of AMD. This is a continuation proposal aimed at expanding the scope of the studies proposed originally. The main aim of these studies is to use the state-of-the-art, non-invasive technique of laser Doppler flowmetry to investigate whether choroidal blood flow and its regulation are abnormal in AMD. In addition we will investigate whether a more abnormal choroidal circulation is associated with a higher risk of developing choroidal neovascularization and the more advanced and blinding stages of AMD. A better understanding of the mechanisms associated with the development of AMD could, in the long run, help us devise new treatment strategies for this devastating disease. In addition, the knowledge gained through this investigation could also help in the identification of patients at risk of developing choroidal neovascularization, thus enabling earlier treatment.