By D. Virgil Alfaro III et al.
- Learn from a popular workforce of retina surgeons who tackle all facets of administration, together with anatomy, body structure, and pathophysiology; imaging of the macula in ARMD, prevention measures and therapy; and destiny instructions within the field.
- Gain an effective origin in intravenous fluorescein angiography, indocyanine eco-friendly angiography, and optical coherence tomography, in addition to antiVEGE treatment and similar new medicinal drugs, optimizing your prognosis and therapy options.
- Understand the numerous swap within the class process of choroidal neovascular membranes in ARMD.
- Get up to date details on treating ARMD secondary to geographic atrophy via mobile transplantation and pharmacologic therapies.
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Additional info for Age-Related Macular Degeneration
SUBRETINAL INJECTION MODELS CNV has been immunologically and mechanically induced in animal models, primarily by injection of synthetic peptides, viral vectors containing VEGF, cells, and inert synthetic materials. The proximity to the choroidal vasculature along with the perturbation of the RPE caused by the injection itself, when combined with proper angiogenic signals, appears to be sufficient stimuli to encourage invasion of the subretinal space by CNV complexes (196). Subretinal Matrigel Injection Although the pathogenesis of CNV in AMD is not entirely clear, it has been strongly associated with the presence of abnormal extracellular deposits in the space between the RPE and BM (4,6,239,240).
Imamura et al. showed that SOD1 knockout mice display age-related pathologic changes in the retina reminiscent of AMD as early as 7 months of age. Among the most frequent findings were the presence of drusen, the thickening of BM, and the development of CNV (being thereby suitable for simulating wet forms of AMD as well) (76). However, prior to the 7-month period, retinas from these animals were absolutely indistinguishable from age-matched wildtype animals (76). As with many other models, lesions increased in number and severity with age: At 10 months of age, 86% of mice had drusen, compared to very few drusen in age-matched wild-type mice (76), and at a year of age, RPE vacuolization and degenerative changes were noted.
Also, Lassota et al. (238) found that the original surgical technique could be optimized by avoiding RPE removal prior to the BM perforation. Compared to those obtained with the original surgical intervention, CNV membranes induced by using this method were significantly thicker and had a higher cellular content, were more richly vascularized, and also exhibited the highest propensity to leak in fluorescence angiograms. It is important to note that even when the surgical model offers benefits of reduced neuroretinal damage, the technique is limited by higher cost and the necessity of a three-port vitrectomy.
Age-Related Macular Degeneration by D. Virgil Alfaro III et al.