萎缩型老年性黄斑变性的治疗研究进展  

Progress in the treatment of atrophic age-related macular degeneration

作　　者：薛瑢 万光明[1] Xue Rong;Wan Guangming(Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450001, China)

机构地区：[1]郑州大学第一附属医院眼一科,450001

出　　处：《中华眼底病杂志》2019年第1期94-98,共5页Chinese Journal of Ocular Fundus Diseases

基　　金：国家重点研发计划 (2017YFA0105000、2018YFA0107304);河南省科技创新杰出人才项目 (2018JR0005).

摘　　要：萎缩型老年性黄斑变性(AMD)早期可不表现出明显的视觉功能丧失,因而不易被重视;进展至晚期,患者多因黄斑区视网膜地图样萎缩影响夜视力及中心视力而就医。目前用于临床或已进入临床试验治疗萎缩型AMD的药物包括改善脉络膜灌注、减少有害物质蓄积、防止氧化应激损伤、抑制炎症反应的药物以及神经保护剂、脂类代谢药物等。干细胞移植治疗萎缩型AMD是目前最有前景的治疗手段。理论上讲,采用人类干细胞分化来源的视网膜光感受器细胞及RPE细胞替代治疗萎缩型AMD是可行的;但如何提高种子细胞的定向诱导分化效率以及如何保证安全有效的RPE细胞移植及移植后的存活等问题仍亟待解决。目前已有多项研究发现多个基因位点的突变与萎缩型AMD有关,因此基因治疗在疾病的发生发展中也起着重要作用。Abstract Atrophic age-related macular degeneration (AMD) does not show obvious loss of visual function in the early stage, so it is not easy to be taken seriously. In the advanced stage, most of the patients suffered from macular area retinal map atrophy, which affected night vision and central vision. Drugs currently used in clinical or clinical trials to treat atrophic AMD include drugs for improving choroidal perfusion, reducing the accumulation of harmful substances, preventing oxidative stress injury, inhibiting inflammatory reactions, as well as neuroprotectants and lipid metabolism drugs. Stem cell transplantation for atrophic AMD is currently the most promising treatment. In theory, it is feasible to replace atrophic AMD with retinal photoreceptor cells and RPE cells derived from human stem cell differentiation. However, there are still many problems to be solved, such as how to improve the efficiency of directional differentiation of seed cells and how to ensure the safe and effective RPE cell transplantation and survival after transplantation. At present, several studies have found that multiple locus mutations are associated with atrophic AMD, so gene therapy also plays an important role in the development of the disease.

关 键 词：黄斑变性/治疗 地图样萎缩 综述 

分 类 号：R774.5[医药卫生—眼科]