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Impressum
Introduction: Is oxidative damage important in the pathogenesis of age-related macular degeneration?
Pauleikhoff D.
Augenabteilung, St. Franziskus Hospital, Münster
Genetic factors appear to be central in the pathogenesis of AMD, but
enviromental factors influence the clinical appearence and course of the
disease. Because the central retina is especially sensitive to oxidative
damage, antioxidative substances (vitamines, enzymes), smoking etc are
of great importance. A special protective mechanism in the macula against
oxidative damage is the macular pigment. It has a special composition,
but demonstrates a great variation between individuals. This may influence
the amount of oxidative damaged photoreceptors phagocytized and metabolized
by the RPE cells. The developement of lipofuszin granules will result
with major implications for the normal RPE metabolism. Because this not-metabolized
material will also be discharged basally towards the choroid, during life
increasing morphologic and biochemical especially lipid rich changes occur
in Bruch´s Membrane (BM). This will result in decreaced hydrolic
conductivity, changed concentration of growth factors and an inflammation
like reaction in BM. In summary the oxidative damage in the central retina
with consecutive changes in the RPE and BM may play an important role
in the pathogenesis of AMD.