Age‐related maculopathy in the light of ischaemia

Abstract

This manuscript focuses on the pathogenesis of age‐related maculopathy (ARM) and the documentation of new treatments in ARM. Ischaemia will be given special consideration, as it is believed to play a central role in both early ARM and late ARM or age‐related macular degeneration (AMD). Reduced choroidal and retinal blood flow causes ischaemia of Bruch’s membrane, retinal pigment epithelium and neuroretina in the early course of ARM. This is thought to be the primary trigger of the condition. Chronic ischaemia upregulates vascular endothelial growth factor (VEGF), which induces abnormal vessel growth in neovascular AMD. The role of ischaemia in neovascular AMD is supported by the evidence of effective new treatments targeting VEGF.

Key words:

• age‐related maculopathy
• hypoxia
• ischaemia
• mfERG
• multifocal electroretinogram

ACKNOWLEDGEMENT

The authors thank Brian Brown and Andrew J Zele for constructive discussions. This paper was presented in part at the 2006 Optometry Congress Australia (OCA) in Brisbane.