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Wang D, Chen Y, Li J, Wu E, Tang T, Singla RK, Shen B, Zhang M. Natural products for the treatment of age-related macular degeneration. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 130:155522. [PMID: 38820665 DOI: 10.1016/j.phymed.2024.155522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 02/08/2024] [Accepted: 03/07/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Age-related macular degeneration (AMD) is a chronic retinal disease that significantly influences the vision of the elderly. PURPOSE There is no effective treatment and prevention method. The pathogenic process behind AMD is complex, including oxidative stress, inflammation, and neovascularization. It has been demonstrated that several natural products can be used to manage AMD, but systematic summaries are lacking. STUDY DESIGN AND METHODS PubMed, Web of Science, and ClinicalTrials.gov were searched using the keywords "Biological Products" AND "Macular Degeneration" for studies published within the last decade until May 2023 to summarize the latest findings on the prevention and treatment of age-related macular degeneration through the herbal medicines and functional foods. RESULTS The eligible studies were screened, and the relevant information about the therapeutic action and mechanism of natural products used to treat AMD was extracted. Our findings demonstrate that natural substances, including retinol, phenols, and other natural products, prevent the development of new blood vessels and protect the retina from oxidative stress in cells and animal models. However, they have barely been examined in clinical studies. CONCLUSION Natural products could be highly prospective candidate drugs used to treat AMD, and further preclinical and clinical research is required to validate it to control the disease.
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Affiliation(s)
- Dongyue Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Yi Chen
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Jiakun Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; Joint Laboratory of Artificial Intelligence for Critical Care Medicine, Department of Critical Care Medicine and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, PR China
| | - Erman Wu
- Joint Laboratory of Artificial Intelligence for Critical Care Medicine, Department of Critical Care Medicine and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, PR China
| | - Tong Tang
- Joint Laboratory of Artificial Intelligence for Critical Care Medicine, Department of Critical Care Medicine and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, PR China
| | - Rajeev K Singla
- Joint Laboratory of Artificial Intelligence for Critical Care Medicine, Department of Critical Care Medicine and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, PR China; School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab-144411, India.
| | - Bairong Shen
- Joint Laboratory of Artificial Intelligence for Critical Care Medicine, Department of Critical Care Medicine and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, PR China.
| | - Ming Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
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Sorenson CM, Song YS, Zaitoun IS, Wang S, Hanna BA, Darjatmoko SR, Gurel Z, Fisk DL, McDowell CM, McAdams RM, Sheibani N. Caffeine Inhibits Choroidal Neovascularization Through Mitigation of Inflammatory and Angiogenesis Activities. Front Cell Dev Biol 2021; 9:737426. [PMID: 34722519 PMCID: PMC8551619 DOI: 10.3389/fcell.2021.737426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/13/2021] [Indexed: 12/20/2022] Open
Abstract
Adenosine receptors (AR) are widely expressed in a variety of tissues including the retina and brain. They are involved in adenosine-mediated immune responses underlying the onset and progression of neurodegenerative diseases. The expression of AR has been previously demonstrated in some retinal cells including endothelial cells and retinal pigment epithelial cells, but their expression in the choroid and choroidal cells remains unknown. Caffeine is a widely consumed AR antagonist that can influence inflammation and vascular cell function. It has established roles in the treatment of neonatal sleep apnea, acute migraine, and post lumbar puncture headache as well as the neurodegenerative diseases such as Parkinson and Alzheimer. More recently, AR antagonism with caffeine has been shown to protect preterm infants from ischemic retinopathy and retinal neovascularization. However, whether caffeine impacts the development and progression of ocular age-related diseases including neovascular age-related macular degermation remains unknown. Here, we examined the expression of AR in retinal and choroidal tissues and cells. We showed that antagonism of AR with caffeine or istradefylline decreased sprouting of thoracic aorta and choroid/retinal pigment epithelium explants in ex vivo cultures, consistent with caffeine's ability to inhibit endothelial cell migration in culture. In vivo studies also demonstrated the efficacy of caffeine in inhibition of choroidal neovascularization and mononuclear phagocyte recruitment to the laser lesion sites. Istradefylline, a specific AR 2A antagonist, also decreased choroidal neovascularization. Collectively, our studies demonstrate an important role for expression of AR in the choroid whose antagonism mitigate choroidal inflammatory and angiogenesis activities.
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Affiliation(s)
- Christine M Sorenson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.,McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Yong-Seok Song
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Ismail S Zaitoun
- McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.,Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Shoujian Wang
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Barbara A Hanna
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Soesiawati R Darjatmoko
- McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.,Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Zafer Gurel
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Debra L Fisk
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Colleen M McDowell
- McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.,Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Ryan M McAdams
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Nader Sheibani
- McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.,Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.,Department of Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.,Department of Biomedical Engineering, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
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3
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Jabbehdari S, Handa JT. Oxidative stress as a therapeutic target for the prevention and treatment of early age-related macular degeneration. Surv Ophthalmol 2020; 66:423-440. [PMID: 32961209 DOI: 10.1016/j.survophthal.2020.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/10/2020] [Accepted: 09/14/2020] [Indexed: 12/13/2022]
Abstract
Age-related macular degeneration, the leading cause of irreversible visual loss among older adults in developed countries, is a chronic, multifactorial, and progressive disease with the development of painless, central vision loss. Retinal pigment epithelial cell dysfunction is a core change in age-related macular degeneration that results from aging and the accumulated effects of genetic and environmental factors that, in part, is both caused by and leads to oxidative stress. In this review, we describe the role of oxidative stress, the cytoprotective oxidative stress pathways, and the impact of oxidative stress on critical cellular processes involved in age-related macular degeneration pathobiology. We also offer targeted therapy that may define how antioxidant therapy can either prevent or improve specific stages of age-related macular degeneration.
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Affiliation(s)
- Sayena Jabbehdari
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - James T Handa
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
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4
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Leisser C, Stimpfl T, Ruiss M, Pilwachs C, Hienert J, Fisus A, Burgmüller W, Findl O, Kronschläger M. Caffeine Uptake into the Vitreous after Peroral Coffee Consumption. Ophthalmic Res 2020; 63:533-540. [PMID: 32146476 DOI: 10.1159/000507026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 03/02/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Caffeine and its metabolites have antioxidant activity, scavenging reactive oxygen species. The aim of our study was to measure caffeine concentrations in vitreous samples after peroral caffeine intake. METHODS This prospective study included patients scheduled for 23-G pars plana vitrectomy with membrane peeling due to epiretinal membranes. The study was performed in two parts: in the first part, patients were recruited into three different groups: group A consisted of habitual coffee drinkers who agreed to drink coffee containing 180 mg caffeine 1 h before surgery (n = 10), group B consisted of habitual coffee drinkers who were not offered coffee before surgery (n = 5), and group C consisted of non-habitual coffee drinkers, forming the control group (n = 5). In the second part (group D) patients (habitual coffee drinkers) agreed to give additional blood serum samples for measurement of caffeine concentration. Harvested samples of vitreous (groups A-D), epiretinal membranes (groups A-C), and blood serum samples (group D) were examined for concentrations of caffeine with gas chromatography-mass spectrometry. RESULTS Samples of 40 eyes of 40 patients were harvested. The concentrations of caffeine in the vitreous samples were 1,998 ± 967 ng/mL in group A and 1,108 ± 874 ng/mL in group B. In group C, caffeine concentrations were below 176 ng/mL in all vitreous samples. Both groups A and B had significantly higher concentrations of caffeine in the vitreous samples than group C (p < 0.002, p < 0.01, Mann-Whitney U test). Caffeine concentrations in epiretinal membranes were below the limits of detection. Correlation of caffeine concentrations between blood serum samples and vitreous samples in group D was high, with significantly higher caffeine concentrations in the blood serum. CONCLUSION Coffee consumption leads to significant caffeine levels in the vitreous compared to patients in the control group, and caffeine concentrations in the vitreous showed a high correlation to blood serum concentrations of caffeine after peroral coffee consumption.
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Affiliation(s)
- Christoph Leisser
- Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital Vienna, Vienna, Austria
| | - Thomas Stimpfl
- Clinical Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Manuel Ruiss
- Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital Vienna, Vienna, Austria
| | - Caroline Pilwachs
- Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital Vienna, Vienna, Austria
| | - Julius Hienert
- Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital Vienna, Vienna, Austria
| | - Andreea Fisus
- Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital Vienna, Vienna, Austria
| | - Wilhelm Burgmüller
- Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital Vienna, Vienna, Austria
| | - Oliver Findl
- Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital Vienna, Vienna, Austria,
| | - Martin Kronschläger
- Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital Vienna, Vienna, Austria
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5
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Uzun F, Aslan MG, Öter K, Kaim M. The acute effects of single cup of coffee on ocular biometric parameters in healthy subjects. J Curr Ophthalmol 2019; 31:394-398. [PMID: 31844789 PMCID: PMC6896472 DOI: 10.1016/j.joco.2019.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 04/27/2019] [Accepted: 05/09/2019] [Indexed: 12/02/2022] Open
Abstract
Purpose To evaluate ocular biometric changes in healthy subjects after caffeine consumption from a cup of coffee. Methods A total of 36 subjects were included in this prospective observational study. Axial length (AL) and anterior segment parameters including aqueous depth (AD), anterior chamber depth (ACD), lens thickness (LT), and central corneal thickness (CCT) were measured with optic biometry, Lenstar LS 900 (Haag-Streit, Inc., Koeniz, Switzerland) before and 1 and 4 h after ingesting a cup of coffee (60 mg caffeine/100 mL). Results Mean age of the participants was 30.05 ± 7.43 years (range, 19–45). At baseline, 1st, and 4th hour, AL values were 23.9 ± 1.04 mm, 23.91 ± 1.04 mm, and 23.89 ± 1.04 mm, respectively, and no significant difference was observed (P>0.05). At baseline, 1st, and 4th hour, AD values were 3.06 ± 0.3 mm, 3.11 ± 0.3 mm, and 3.09 ± 0.3 mm, and ACD values were 3.6 ± 0.32, 3.66 ± 0.31, and 3.64 ± 0.31, respectively. AD and ACD values were significantly greater than baseline at 1st and 4th hours following coffee ingestion. Coffee intake caused a significant reduction in LT, compared with baseline and at the 1st and 4th hours which were 3.76 ± 0.28 mm, 3.69 ± 0.32 mm, and 3.72 ± 0.27 mm, respectively. No statistically significant difference was determined in between the 3 measurements in terms of CCT (P>0.05). Conclusion Caffeine causes a significant increase in AD and ACD and a significant decrease in LT following oral intake, for at least 4 h.
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Affiliation(s)
- Feyzahan Uzun
- Recep Tayyip Erdogan University Medical School, Department of Ophthalmology, Rize, Turkey
| | - Mehmet Gökhan Aslan
- Recep Tayyip Erdogan University Medical School, Department of Ophthalmology, Rize, Turkey
| | - Kamile Öter
- Recep Tayyip Erdogan University Medical School, Department of Ophthalmology, Rize, Turkey
| | - Muhammet Kaim
- Recep Tayyip Erdogan University Medical School, Department of Ophthalmology, Rize, Turkey
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Raimundo M, Mira F, Cachulo MDL, Barreto P, Ribeiro L, Farinha C, Laíns I, Nunes S, Alves D, Figueira J, Merle BMJ, Delcourt C, Santos L, Silva R. Adherence to a Mediterranean diet, lifestyle and age-related macular degeneration: the Coimbra Eye Study - report 3. Acta Ophthalmol 2018; 96:e926-e932. [PMID: 30218481 DOI: 10.1111/aos.13775] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 03/06/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE To characterize the lifestyle and nutritional risk profile associated with the Mediterranean diet in a Portuguese population with and without age-related macular degeneration (AMD). METHODS Nested case-control study (n = 883) within the Coimbra Eye Study, including 434 subjects with AMD and 449 age- and sex-matched subjects without AMD. All enrolled subjects underwent a full risk assessment, including lifestyle-related risk factors and a thorough food frequency questionnaire. This allowed us to build an adherence score to the Mediterranean diet (mediSCORE, range 0-9) constructed from individual food intakes. Food intake was also further analysed by conversion to micronutrient consumption. RESULTS Our results suggest that physical activity has a protective role in AMD [p = 0.018 after multivariate adjustment, OR: 0.69 (0.51-0.93)]. High (mediSCORE ≥6) was also found to be protective [p = 0.041, OR: 0.62 (95% CI: 0.38-0.97)]. Food group analysis unveiled a specific protective role for increased fruits consumption (p = 0.029). Finally, micronutrient analysis revealed a protective role associated with increased consumption of caffeine, fibres, beta-carotene, vitamin C and vitamin E (p < 0.05). CONCLUSION High mediSCORE appears to confer protection against the development of AMD in a Mediterranean population. This effect is driven by increased consumption of fruits and some antioxidant micronutrients, which emerged as statistically significant protective factors. Further studies are required to establish dietary recommendations with clinical application.
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Affiliation(s)
- Miguel Raimundo
- Ophthalmology Department; Coimbra University Hospital Centre (CHUC); Coimbra Portugal
| | - Filipe Mira
- Faculty of Medicine; Institute for Biomedical Imaging and Life Sciences; University of Coimbra (FMUC-IBILI); Coimbra Portugal
| | - Maria da Luz Cachulo
- Ophthalmology Department; Coimbra University Hospital Centre (CHUC); Coimbra Portugal
- Faculty of Medicine; Institute for Biomedical Imaging and Life Sciences; University of Coimbra (FMUC-IBILI); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Patrícia Barreto
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Luísa Ribeiro
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Cláudia Farinha
- Ophthalmology Department; Coimbra University Hospital Centre (CHUC); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Inês Laíns
- Ophthalmology Department; Coimbra University Hospital Centre (CHUC); Coimbra Portugal
- Massachusetts Eye and Ear Infirmary; Harvard Medical School; Boston MA USA
| | - Sandrina Nunes
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Dalila Alves
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - João Figueira
- Ophthalmology Department; Coimbra University Hospital Centre (CHUC); Coimbra Portugal
- Faculty of Medicine; Institute for Biomedical Imaging and Life Sciences; University of Coimbra (FMUC-IBILI); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
| | - Bénédicte MJ Merle
- Inserm, Bordeaux Population Health Research Center; Team LEHA; UMR 1219; University of Bordeaux; Bordeaux France
| | - Cécile Delcourt
- Inserm, Bordeaux Population Health Research Center; Team LEHA; UMR 1219; University of Bordeaux; Bordeaux France
| | - Lèlita Santos
- Faculty of Medicine; Institute for Biomedical Imaging and Life Sciences; University of Coimbra (FMUC-IBILI); Coimbra Portugal
- Internal Medicine; Coimbra University Hospital Centre; Coimbra Portugal
| | - Rufino Silva
- Ophthalmology Department; Coimbra University Hospital Centre (CHUC); Coimbra Portugal
- Faculty of Medicine; Institute for Biomedical Imaging and Life Sciences; University of Coimbra (FMUC-IBILI); Coimbra Portugal
- Association for Innovation and Biomedical Research on Light and Image (AIBILI); Coimbra Portugal
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Abstract
Caffeine, a popular psychostimulant that acts as an adenosine receptor antagonist, is the most widely used drug in history, consumed daily by people worldwide. Knowledge of the physiological and pathological effects of caffeine is crucial in improving public health because of its widespread use. We provide a summary of the current evidence on the effect of caffeine on the eye. Most of the research conducted to date is in relation to cataract and glaucoma, two of the most common eye diseases among the elderly.
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Zhang K, Zhong Q, Chen S, Guo C, Xu Y, Liu Y, Sun W, Yan Y, Zhao P. An epidemiological investigation of age-related macular degeneration in aged population in China: the Hainan study. Int Ophthalmol 2017; 38:1659-1667. [PMID: 28688024 PMCID: PMC6061009 DOI: 10.1007/s10792-017-0639-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/27/2017] [Indexed: 11/29/2022]
Abstract
Purpose The aim of this study was to investigate the prevalence of age-related macular degeneration (AMD) and the risk factors in the residents aged ≥50 years in Hainan Province. Methods Random sampling was carried out in four separated cities in Hainan Province in 2015. All the subjects accomplished the standard questionnaire and ocular examinations. The diagnosis of AMD was performed based on the criteria proposed by Beckman Initiative for Macular Research Classification Committee. Results Three hundred and fifty-seven subjects (15.6%) were diagnosed with AMD, including 267 (11.7%) of early AMD, 64 (2.80%) of intermediate AMD and 24 (1.1%) of late AMD, respectively. The factors associated with the prevalence of AMD included age, educational level, smoking, outdoor activities and diet. The prevalence of AMD increased with age, lower educational level, smoking or less outdoor activities. The prevalence of AMD in those with a diet of meat or eggs was higher compared with a diet of vegetables or fish. The prevalence of early, intermediate and late AMD in the aged population in Hainan Province was 11.7, 2.8 and 1.1%, respectively. Conclusions Age and smoking were the risk factors for AMD, while the educational level and outdoor activities were the protective factors. Early AMD mostly occurred in those aged 50–59 years and 60–69 years, while intermediate and late AMD occurred in 70–79 years and older than 80 years.
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Affiliation(s)
- Kaiyan Zhang
- Department of Ophthalmology, Hainan Provincial People's Hospital, Haikou, 570311, China.
| | - Qionglei Zhong
- Department of Ophthalmology, Hainan Provincial People's Hospital, Haikou, 570311, China
| | - Siying Chen
- Department of Ophthalmology, Hainan Provincial People's Hospital, Haikou, 570311, China
| | - Chuanxian Guo
- Department of Ophthalmology, Hainan Provincial People's Hospital, Haikou, 570311, China
| | - Yan Xu
- Department of Ophthalmology, Hainan Provincial People's Hospital, Haikou, 570311, China
| | - Yang Liu
- Department of Ophthalmology, Hainan Provincial People's Hospital, Haikou, 570311, China
| | - Wen Sun
- Department of Ophthalmology, Hainan Provincial People's Hospital, Haikou, 570311, China
| | - Yijie Yan
- Department of Ophthalmology, Hainan Provincial People's Hospital, Haikou, 570311, China
| | - Puning Zhao
- Department of Ophthalmology, Hainan Provincial People's Hospital, Haikou, 570311, China
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Boia R, Ambrósio AF, Santiago AR. Therapeutic Opportunities for Caffeine and A 2A Receptor Antagonists in Retinal Diseases. Ophthalmic Res 2016; 55:212-8. [DOI: 10.1159/000443893] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 01/09/2016] [Indexed: 11/19/2022]
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10
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Risk factors for age-related maculopathy. J Ophthalmol 2009; 2009:360764. [PMID: 20339564 PMCID: PMC2836883 DOI: 10.1155/2009/360764] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2009] [Accepted: 07/08/2009] [Indexed: 11/20/2022] Open
Abstract
Age-related maculopathy (ARM) is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age-related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715/HTRA1, demonstrating that environmental and genetic factors are important for the development of ARM suggesting that gene-environment interaction plays an important role in the pathogenesis of this condition.
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11
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Karnon J, Czoski-Murray C, Smith KJ, Brand C. A Hybrid Cohort Individual Sampling Natural History Model of Age-Related Macular Degeneration: Assessing the Cost-Effectiveness of Screening Using Probabilistic Calibration. Med Decis Making 2009; 29:304-16. [DOI: 10.1177/0272989x08327491] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Age-related macular degeneration (AMD) is a leading cause of visual impairment and blindness. It is likely that treatment of AMD at earlier stages is more effective than later treatment; thus, screening for AMD should be considered. The aim of this study was to develop a natural history model of AMD to estimate the cost-effectiveness of screening. Methods. A hybrid cohort/individual sampling decision analytic model was developed. Primary data sets, expert elicitation, and data from the literature were used to populate the model. To incorporate joint parameter uncertainty, and to populate unobservable parameters, an innovative form of probabilistic calibration was applied to a range of output parameters. Results. In the reference case, annual screening from age 60 y is the most cost-effective option, although this is subject to high levels of uncertainty. Alternative, age-specific utility values show that screening is predicted to be less cost-effective, assuming interventions that reduce progression to wet AMD moderately improve the cost-effectiveness of screening, whereas the addition of anti—vascular endothelial growth factor therapy for juxtafoveal or subfoveal wet AMD lesions improves the cost-effectiveness of screening significantly. Conclusions. The extent of the uncertainty around the mean results, and the additional resources and possible reorganization of services required to implement screening, indicate that it may be preferable to reduce the level of uncertainty before implementing screening for AMD. Initial actions may be best targeted at assessing how routine data may be used to describe clinical presentation, a screening pilot study, and a secondary costing study.
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Affiliation(s)
- Jonathan Karnon
- School of Population Health and Clinical Practice, University of Adelaide, Australia
| | | | - Kevin J. Smith
- School of Health and Related Research, University of Sheffield, United Kingdom
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12
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Ambati J, Ambati BK, Yoo SH, Ianchulev S, Adamis AP. Age-related macular degeneration: etiology, pathogenesis, and therapeutic strategies. Surv Ophthalmol 2003; 48:257-93. [PMID: 12745003 DOI: 10.1016/s0039-6257(03)00030-4] [Citation(s) in RCA: 609] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Age-related macular degeneration is the principal cause of registered legal blindness among those aged over 65 in the United States, western Europe, Australia, and Japan. Despite intensive research, the precise etiology of molecular events that underlie age-related macular degeneration is poorly understood. However, investigations on parallel fronts are addressing this prevalent public health problem. Sophisticated biochemical and biophysical techniques have refined our understanding of the pathobiology of drusen, geographic atrophy, and retinal pigment epithelial detachments. Epidemiological identification of risk factors has facilitated an intelligent search for underlying mechanisms and fueled clinical investigation of behavior modification. Gene searches have not only brought us to the cusp of identifying the culpable gene loci in age-related macular degeneration, but also localized genes responsible for other macular dystrophies. Recent and ongoing investigations, often cued by tumor biology, have revealed an important role for various growth factors, particularly in the neovascular form of the condition. Transgenic and knockout studies have provided important mechanistic insights into the development of choroidal neovascularization, the principal cause of vision loss in age-related macular degeneration. This in turn has culminated in preclinical and clinical trials of directed molecular interventions.
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Affiliation(s)
- Jayakrishna Ambati
- Ocular Angiogenesis Laboratory, Department of Ophthalmology, University of Kentucky, Lexington, USA
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