Factors determining age-related macular degeneration: a current view

Rasa Liutkevičienė¹, Vaiva Lesauskaitė², Virginija Ašmonienė³, Dalia Žaliūnienė¹, Vytautas Jašinskas¹

¹Department of Ophthalmology, Kaunas University of Medicine, ²Department of Cardiac Pathology, Institute of Cardiology, Kaunas University of Medicine, ³Laboratory of Neuroscience, Institute for Biomedical Research, Kaunas University of Medicine, Lithuania

Key words: age-related macular degeneration; risk factors; gene; neovascularization; matrix metalloproteinases.

Summary. Age-related macular degeneration affects the macula and is the leading cause of significant and irreversible central visual loss. It is the most common cause of visual loss in people older than 60 years. The pathogenesis of age-related macular degeneration is complex and not completely understood. It is thought that age-related macular degeneration has a multifactorial etiology, the development of which may be caused by interrelation of environmental and genetic factors and body characteristics. In this article, risk factors such as age, gender, cigarette smoking, color of the iris, nutrition, body mass index, oxidative stress, and genetic factors (complement factor H gene, Apo E gene, and others) are reviewed. Here, choroidal neovascularization process, in which hypoxia, inflammatory process, and proteolytic enzymes play a determinant role, is discussed. Considerable attention is paid to genetic polymorphism of matrix metalloproteinases, especially to matrix metalloproteinases 2 and 9, respectively gelatinases A and B, also to matrix metalloproteinase 9.

Correspondence to R. Liutkevičienė, Department of Ophthalmology, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail: rliutkeviciene@gmail.com

Received 1 September 2009, accepted 5 February 2010