These

immature blood vessels leak fluid below or within the retina. It is convenient to dichotomize the pathology of “wet” and “dry” forms of the disease based on the presence or absence, respectively, of CNV. However, as an understanding BAY 73-4506 molecular weight of AMD pathogenesis improves, emerging evidence indicates that significant overlap exists in the underlying mechanisms of these seemingly disparate clinical conditions. In spite of this apparent overlapping pathophysiology, the two forms of AMD are indeed somewhat clinically distinct: that is, effective treatment of wet AMD does not typically ameliorate the dry AMD component. Clearly, further clarification of the overlapping and unique processes that lead to wet and dry pathology will be essential for future advances in the prevention and treatment of AMD. ZD1839 research buy For a review of

structural features in the healthy retina versus the AMD-afflicted retina, the reader is referred to excellent reviews elsewhere (Bird, 2010 and Rattner and Nathans, 2006). The features of a healthy ocular fundus is shown in Figure 1A. Relative to the surrounding peripheral retina, the macular region has a high density of photoreceptors. As such, the macula subserves central vision and acuity that enables resolution of fine details, such as edges or borders. The retina consists of multiple cell layers that form an interdependent anatomical and metabolic network. Other notable features of the retina include: the selectively permeable blood-retinal barrier (Cunha-Vaz, 2004), the greatest oxygen consumption per weight of any organ in the body (Warburg, 1928), and immune privilege (Streilein, 2003). Geographic Atrophy. A representative eye with GA is shown in Figure 1B. AMD primarily affects the macular region of the retina, with relative sparing of the surrounding peripheral retina. AMD Thiamine-diphosphate kinase is defined by confluent regions of drusen, which are multicomponent, heterogeneous aggregates that lie both external and internal to the RPE cells ( Klein et al.,

2008 and Zweifel et al., 2010). The emergence and “growth” of drusen occurs slowly over years or decades. RPE cell death and synaptic dysfunction accompany underlying drusen ( Johnson et al., 2005), although the cause-effect relationship of drusen and retinal degeneration (which may be reciprocal) is not fully understood. Choroidal Neovascularization. A representative eye with CNV is shown in Figure 1C. CNV also primarily affects the macula. If left untreated, it can lead to severe blindness with scarring within several months. Assessment of CNV is typically made using fluorescein angiography or optical coherence tomography to measure characteristic lesions with leakage of blood or plasma proteins from immature choroidal blood vessels. This review is focused on the mechanistic underpinnings of AMD.