Recent advances of age-related maculopathy susceptibility 2 / 中华实验眼科杂志

The prevalence of age-related macular degeneration (AMD) is increasing yearly,and AMD has become the first cause of elderly vision irreversible loss.In China,an aging society is developing,so the prevention and therapy for AMD is faced with a new challenge.Thc multi-faceted study on AMD has become a focus of fundus disease in ophthalmology.AMD is thought to be a multifactorial-induced disease,and it is closely related to age,genetic and environmental factors.But its pathogenesis is not understood enough up to now.In recent years,epidemiological study revealed that the chromosome 10q26 has multiple polymorphic loci.Age-related maculopathy susceptibility 2 ( ARMS2,rs10490924 ) is reported to be a major risk factor of AMD in the yellow race.In this paper,the ARMS2 gene epidemiology,cell positioning and related treatment were reviewed.

Expression and location of ARMS2 protein in normal eye tissue / 中华实验眼科杂志

Background Researches determined that the alteration of A69S locus of age-related maculopathy susceptibility 2 ( ARMS2 ) gene is closely associated with the pathogenesis and progression of age-related maculopathy ( AM D ).However,the location of ARMS2 protein in normal eye tissue is still in controversy,therefore,its function is below understanding up to now.Objective The goal of this laboratory work was to investigate the distribution,expression and location of ARMS2 protein in normal adult retina and choroid as well as in retinal pigment epithelial (RPE) cells and lay a basis for exploring further its function in the protein level.Methods Ten donor eyeballs of normal adult male with the age from 28-42 years were collected in eye bank of Qingdao Eye Hospital.The frozen sections of the retina and choroid were prepared for the detection and location of ARMS2 in 3 eyes by immunofluorescence under the confocal laser microscope.The retina was isolated for the primary culture of RPE cells using explant culture method.The cells were then identified by CK32 antibody by immunofluorescence.The distribution and expression of the ARMS2 protein in retina,ehoroid and RPE cells were determined by immunofluorescence technique.Results ARMS2 protein was strongly expressed in retinal vessel,RPE cell layer,Bruch membrane and choroidal vessel,but weak expression was in retinal ganglion cell layer,inner nuclear layer,outer plexiform layer,outer nuclear layer and inner plexiform layer in the normal eyes.The primarily cultured cells appeared the polygon shape with the abundant pigment in cytoplasm.The immunofluorescence of the cells showed the positive response for CK32,exhibiting the green fluorescence granules in the cytoplasm.The positive expression of ARMS2 protein also was seen in the cytoplasm of RPE cells,appearing the red fluorescence.Conclusions ARMS2 protein mainly distribute and locate retinal and choroidal vessels,RPE cells and Bruch membrane in normal eye.

Usefulness of Brachial-Ankle Pulse Wave Velocity and Ankle-Brachial Index as Predictors of Early Age-Related Maculopathy

PURPOSE: Age-related maculopathy (ARM) is a major cause of blindness. For this reason, an early predictor of ARM is necessary for early detection and preventive therapy. The present study investigated arterial stiffness and stenosis using ankle brachial index (ABI) and pulse wave velocity (PWV) and analyzed whether arterial stiffness was affected by the extent of ARM. METHODS: A total of 257 randomized patients were enrolled in the present study. All participants underwent baPWV, ABI, blood pressure, total cholesterol, and triglyceride evaluation and were questioned regarding their history of smoking. The extent of ARM was expressed using Wisconsin ARM grading. RESULTS: Of the 257 patients, 29 were diagnosed with early ARM using Wisconsin ARM grading. The average age of the ARM group was 53 +/- 6.56 years and was significantly greater than the average 45.93 +/- 8.61 years in the non-ARM group. Other than ankle-brachial index, the clinical variables showed no significant differences after a refining process for age-related variables. Ankle-brachial index was significantly lower in the ARM group than it was in the non-ARM group (1.08 +/- 0.052, 1.12 +/- 0.051, respectively). CONCLUSIONS: The ARM group showed significantly increased arterial stenosis. The present study provides a basis for the use of PWV in the early detection of ARM; however, longitudinal studies employing a larger population are required to determine the diagnostic and prognostic implications of PWV in ARM.

Estimated Prevalence and Risk Factor for Age-related Maculopathy

PURPOSE: To assess the estimate prevalence and risk factors for age-related maculopathy (ARM) in Seoul, Korea. PATIENTS AND METHODS: We examined 9,530 subjects with, 40 years of age or older between January 2006 and December 2006 in Seoul, Korea. Subjects underwent fundus photography, clinical examinations (including blood analyses), and completed detailed questionnaires. Fundus images were graded according to definitions from the Wisconsin Age-Related Maculopathy Grading System. RESULTS: ARM was present in 235 subjects, corresponding to an estimate prevalence of 2.46%. Hepatitis B infection (positive status for HBsAg and HBcAb), serum triglyceride levels and high density lipoprotein levels remained as significant risk factors after age-adjustment. Multivariate analyses showed that the prevalence of ARM was significantly higher in older subjects [odds ratio (OR) 1.134; 95% CI 1.114-1.154] and those who were seropositive for hepatitis B surface antigen (OR 2.566; 95% CI 1.519-4.335). CONCLUSION: The estimated prevalence of ARM was 2.46%. Age and hepatitis B infection may increase the risk of ARM.

Assessment of Retinal Ganglion Cell using Retinal Nerve Fiber Layer Photography in Age-related Macular Degeneration

PURPOSE: To determine the loss of ganglion cell layer (GCL) neurons in patients with age-related macular degeneration (AMD) with choroidal neovascularization (CNV). METHODS: Retinal nerve fiber layer (RNFL) photography was taken in patients with AMD with CNV to assess the presence of RNFL defects in the papillomacular bundle area. Patients with other ocular disorders or a history of previous intraocular surgery or laser treatment were excluded from this study. RESULTS: Eighty-five eyes in 65 patients were included, of which only one (1.2%) showed papillomacular bundle defects in association with CNV. CONCLUSIONS: From this study, the majority of the patients with AMD with CNV had no papillomacular bundle defect, which demonstrates that considerable amount of GCL is maintained in AMD.

ICG-enhanced digital angiography and photocoagulation of choroidal neovascularization in age-related macular degeneration

Choroidal neovascular membranes are often poorly defined on fluorescein angiography because of fluorescein leakage or blockage of hyperfluorescence by overlying hemorrhage, lipid, turbid fluid, or pigment. Indocyanine green (ICG) is a highly protein-bound dye in the near infrared portion of the spectrum. Therefore, ICG remained in and around the neovascular membrane and enhanced the visualization of certain membranes poorly defined with fluorescein. ICG penetrated through the overlying turbid tissue, and improved the visualization of the underlying choroidal neovascular membrane. Using an infrared angiography system, the authors obtained 21 ICG-angiograms with suspected choroidal neovascularization, and compared them to fluorescein angiograms. In 5 of the 21 eyes, occult choroidal neovascularization was well delineated on the ICG angiograms. In 2 eyes, we were able to detect a well-defined choroidal neovascular membrane underlying a subretinal hemorrhage. In 12 of the 21 eyes with choroidal neovascular membrane, we performed argon-green laser photocoagulation applying the overlay technique of the ICG angiogram to red-free photo or the early fluorescein angiogram, and evaluated the effect of full coverage laser treatment.