Progression of Early Atrophic Lesions in Age-related Macular degeneration

摘要 我们将重点关注之前在很大程度上未被探索但高度相关的时间窗口 老年性黄斑变性(AMD)，即“早期萎缩性AMD”。我们假设一种治疗效果 在早期萎缩性AMD可能会挽救很大一部分患者的进行性视觉功能丧失 而且，在这个时间窗口冒险干预似乎比在AMD早期阶段更有理由。vbl.反对，反对 在这样的背景下，全面了解了自然疾病的发展在这方面的潜力 治疗保证金是必不可少的。我们将实施创新的多模式高分辨率视网膜成像， 全面的功能测试和视觉相关生活质量(VRQOL)评估 前瞻性纵向研究中的标准化和探索性分析策略。这将使我们能够 描述和量化脑微结构的变化以及相关的功能和VRQOL缺陷 早期萎缩性病变的眼睛具有前所未有的准确性。最强风险因素的知识 疾病进展加速将有助于识别视觉功能丧失风险最高的患者。 此外，我们关于疾病阶段特定风险因素的假设可能会指导治疗靶点的选择 在萎缩性AMD的早期尤其易感。针对特定表型和疾病量身定做治疗方法 分期可能是预防不可逆性视力丧失和相关的生活质量下降的关键 AMD。

SUMMARY We will focus on a previously largely under-explored but highly relevant time window in progression of age-related macular degeneration (AMD), i.e., `early atrophic AMD'. We postulate that a therapeutic effect in early atrophic AMD would probably save a large proportion of patients from progressive visual function loss and that it seems more justifiable to risk interventions in this time window than in earlier AMD stages. Against this background, a comprehensive knowledge of the natural disease progression in this potential therapeutic margin is essential. We will implement innovative multimodal high-resolution retinal imaging, comprehensive functional testing, and assessment of vision-related quality of life (VRQoL) combined with standardized and exploratory analysis strategies in a prospective, longitudinal study. This will enable us to characterize and quantify the microstructural changes and associated functional and VRQoL deficits in eyes with early atrophic lesions with unprecedented accuracy. Knowledge of the strongest risk factors for accelerated disease progression will allow identification of patients at highest risk for visual function loss. Moreover, our hypothesis on disease-stage specific risk-factors may guide selection of therapeutic targets that are particularly susceptible in early atrophic AMD. Tailoring therapeutics to specific phenotypes and disease stages may be key to prevent irreversible vision loss and the associated reduced quality of life in patients with AMD.