The role of oxidative stress in the pathogenesis of age-related macular degeneration

Stephen Beatty, Hui Hiang Koh, M. Phil, David Henson, Michael Boulton

Research output: Contribution to journalArticle

1357 Citations (Scopus)

Abstract

Age-related macular degeneration (AMD) is the leading cause of blind registration in the developed world, and yet its pathogenesis remains poorly understood. Oxidative stress, which refers to cellular damage caused by reactive oxygen intermediates (ROI), has been implicated in many disease processes, especially age-related disorders. ROIs include free radicals, hydrogen peroxide, and singlet oxygen, and they are often the byproducts of oxygen metabolism. The retina is particularly susceptible to oxidative stress because of its high consumption of oxygen, its high proportion of polyunsaturated fatty acids, and its exposure to visible light. In vitro studies have consistently shown that photochemical retinal injury is attributable to oxidative stress and that the antioxidant vitamins A, C, and E protect against this type of injury. Furthermore, there is strong evidence suggesting that lipofuscin is derived, at least in part, from oxidatively damaged photoreceptor outer segments and that it is itself a photoreactive substance. However, the relationships between dietary and serum levels of the antioxidant vitamins and age-related macular disease are less clear, although a protective effect of high plasma concentrations of α-tocopherol has been convincingly demonstrated. Macular pigment is also believed to limit retinal oxidative damage by absorbing incoming blue light and/or quenching ROIs. Many putative risk-factors for AMD have been linked to a lack of macular pigment, including female gender, lens density, tobacco use, light iris color, and reduced visual sensitivity. Moreover, the Eye Disease Case-Control Study found that high plasma levels of lutein and zeaxanthin were associated with reduced risk of neovascular AMD. The concept that AMD can be attributed to cumulative oxidative stress is enticing, but remains unproven. With a view to reducing oxidative damage, the effect of nutritional antioxidant supplements on the onset and natural course of age-related macular disease is currently being evaluated. Copyright (C) 2000 Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)115-134
Number of pages20
JournalSurvey of Ophthalmology
Volume45
Issue number2
DOIs
StatePublished - 2000
Externally publishedYes

Fingerprint

Macular Degeneration
Oxidative Stress
Antioxidants
Light
Oxygen
Lipofuscin
Lutein
Singlet Oxygen
Tocopherols
Eye Diseases
Wounds and Injuries
Tobacco Use
Iris
Vitamin A
Unsaturated Fatty Acids
Vitamin E
Oxygen Consumption
Vitamins
Hydrogen Peroxide
Lenses

Keywords

  • Age-related macular degeneration
  • Antioxidants
  • Free radicals
  • Macular pigment
  • Oxidative stress
  • Reactive oxygen intermediates

ASJC Scopus subject areas

  • Ophthalmology

Cite this

The role of oxidative stress in the pathogenesis of age-related macular degeneration. / Beatty, Stephen; Koh, Hui Hiang; Phil, M.; Henson, David; Boulton, Michael.

In: Survey of Ophthalmology, Vol. 45, No. 2, 2000, p. 115-134.

Research output: Contribution to journalArticle

Beatty, Stephen ; Koh, Hui Hiang ; Phil, M. ; Henson, David ; Boulton, Michael. / The role of oxidative stress in the pathogenesis of age-related macular degeneration. In: Survey of Ophthalmology. 2000 ; Vol. 45, No. 2. pp. 115-134.
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