The Experts below are selected from a list of 291 Experts worldwide ranked by ideXlab platform
Emily Y Chew - One of the best experts on this subject based on the ideXlab platform.
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Therapy of Nonexudative Age-Related Macular Degeneration
Age-related Macular Degeneration Diagnosis and Treatment, 2011Co-Authors: Annal D. Meleth, Veena Raiji, Nupura Krishnadev, Emily Y ChewAbstract:Age related Macular Degeneration (AMD) is the leading cause of blindness among adults over the age of 65 in the Western world. The prevalence of AMD is expected to increase dramatically, from 1.75 million in 2000 to 2.95 million in 2020, due to the rapidly aging population. Given the large and now increasing burden of disease, the identification of modifiable risk factors and new avenues for preventive treatment has become increasingly important. The pathogenesis of Macular Degeneration is multi-factorial with genetic, environmental, and physiologic components. The retina is uniquely susceptible to oxidative damage, given its high metabolic activity and daily exposure to light. In addition, the presence of large numbers of lipids with double bonds makes it an ideal target for reactive oxygen species. The increasing incidence of Macular Degeneration with advancing age may be related to gradual dysfunction and Degeneration of retinal tissues as oxidative damage accumulates. This cumulative damage may result in physiologic dysfunction, in addition to impaired auto-regulation with restricted exchange and processing of nutrients and metabolic byproducts with progressive disease. Nutrients which may modulate this oxidative damage include lutein, zeaxanthin, beta-carotene, C, E, and B vitamins, and zinc. A growing body of scientific evidence also implicates inflammatory processes in the pathogenesis and progression of Macular Degeneration. Clinical evidence suggests a role for a combination of antioxidants in reducing progression of AMD and a potential role for omega-3 fatty acids and Macular xanthophylls in the prevention and treatment of Macular Degeneration. The Age Related Eye Disease Study 2 (AREDS2) will further examine the role of these micronutrients in the treatment of AMD.
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Age-related Macular Degeneration.
Lancet (London England), 2008Co-Authors: Hanna R Coleman, Chi-chao Chan, Frederick L Ferris, Emily Y ChewAbstract:Age-related Macular Degeneration is the leading cause of blindness in elderly populations of European descent. The most consistent risk factors associated with this ocular condition are increasing age and cigarette smoking. Genetic investigations have shown that complement factor H, a regulator of the alternative complement pathway, and LOC387715/HtrA1 are the most consistent genetic risk factors for age-related Macular Degeneration. Although the pathogenesis of this disease is unknown, oxidative stress might have an important role. Treatment with antioxidant vitamins and zinc can reduce the risk of developing advanced age-related Macular Degeneration by about a quarter in those at least at moderate risk. Intravitreal injections of ranibizumab, a monoclonal antibody that inhibits all forms of vascular endothelial growth factor, have been shown to stabilise loss of vision and, in some cases, improve vision in individuals with neovascular age-related Macular Degeneration. These findings, combined with assessments of possible environmental and genetic interactions and new approaches to modulate inflammatory pathways, will hopefully further expand our ability to understand and treat age-related Macular Degeneration.
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Age-related Macular Degeneration. Commentary
The Lancet, 2008Co-Authors: Caroline C W Klaver, Hanna R Coleman, Chi-chao Chan, Frederick L Ferris, Arthur A.b. Bergen, Emily Y ChewAbstract:Age-related Macular Degeneration is the leading cause of blindness in elderly populations of European descent. The most consistent risk factors associated with this ocular condition are increasing age and cigarette smoking. Genetic investigations have shown that complement factor H, a regulator of the alternative complement pathway, and LOC387715/HtrA1 are the most consistent genetic risk factors for age-related Macular Degeneration. Although the pathogenesis of this disease is unknown, oxidative stress might have an important role. Treatment with antioxidant vitamins and zinc can reduce the risk of developing advanced age-related Macular Degeneration by about a quarter in those at least at moderate risk. Intravitreal injections ofranibizumab, a monoclonal antibody that inhibits all forms of vascular endothelial growth factor, have been shown to stabilise loss of vision and, in some cases, improve vision in individuals with neovascular age-related Macular Degeneration. These findings, combined with assessments of possible environmental and genetic interactions and new approaches to modulate inflammatory pathways, will hopefully further expand our ability to understand and treat age-related Macular Degeneration.
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Nutritional supplementation in age-related Macular Degeneration.
Current opinion in ophthalmology, 2007Co-Authors: Hanna R Coleman, Emily Y ChewAbstract:Purpose of review This review assesses the current status of the knowledge of the role of nutrition in age-related Macular Degeneration – a leading cause of vision loss in the persons with European ancestry. Recent findings We will evaluate the different nutritional factors and both observational and interventional studies used to assess the association of nutrition with age-related Macular Degeneration. Persons with intermediate risk of age-related Macular Degeneration or advanced age-related Macular Degeneration in one eye are recommended to take the formulation proven in the Age-Related Eye Disease Study (AREDS) to be successful in preventing the development of advanced age-related Macular Degeneration by 25%. The formulation consists of vitamins C, E, beta-carotene and zinc. In addition, observational data suggest that high dietary intake of Macular xanthophylls lutein and zeaxanthin are associated with a lower risk of advanced age-related Macular Degeneration. Similarly, long-chain polyunsaturated fatty acids derived from fish consumption are also associated with a decreased risk of advanced age-related Macular Degeneration. Summary Persons with intermediate age-related Macular Degeneration or advanced age-related Macular Degeneration (neovascular or central geographic atrophy) in one eye should consider taking the AREDS-type supplements. Further evaluation of nutritional factors, specifically, lutein/zeaxanthin and omega-3 fatty acids will be tested in a multicenter controlled, randomized trial – the Age-Related Eye Disease Study 2 (AREDS2).
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Nutritional supplement use and age-related Macular Degeneration.
Current opinion in ophthalmology, 1995Co-Authors: Emily Y ChewAbstract:Age-related Macular Degeneration is one of the leading causes of visual loss among people aged 65 years or older. The causes and factors associated with the progression of age-related Macular Degeneration are unknown presently. Basic research and epidemiologic data support the hypotheses that higher levels of antioxidant vitamins and minerals may protect the eye from the development of age-related Macular Degeneration. For this reason and also because of the lack of effective treatment for most cases of age-related Macular Degeneration, nutritional supplements with antioxidants have emerged as possible therapy for age-related Macular Degeneration. Nutritional supplements are not proven therapy for age-related Macular Degeneration. The potential beneficial effects and adverse side effects of the nutritional supplements have not yet been fully evaluated in carefully conducted clinical trials. Several randomized placebo-controlled clinical trials are presently underway. Results of these studies will provide important data to clarify the potential beneficial and adverse effects of such treatment. Until these results are available, it would be premature to make recommendations in favor of vitamin or mineral supplements.
Paul T. Finger - One of the best experts on this subject based on the ideXlab platform.
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Brachytherapy for Macular Degeneration Associated with Subretinal Neovascularization
Age-Related Macular Degeneration, 2001Co-Authors: Paul T. Finger, Illka Immonen, Jorge Freire, Gary C. BrownAbstract:Macular Degeneration is the leading cause of severe irreversible blindness in the Western world (Bressler et al. 1988; Hyman et al. 1983). Most patients develop the “dry” form characterized by slowly progressive atrophy of the Macular choroid and retina with mild to moderate loss of central vision. In contrast, a minority of patients develop the “wet” form of Macular Degeneration, which is characterized by the development of subretinal neovascularization, leakage, and scarring. Wet Macular Degeneration can be a rapid process destroying central vision in a matter of days, weeks, or months. Such subretinal neovascular events have been associated with age-related Macular Degeneration (ARMD), diabetes, high myopia, histoplasmosis, and laser photocoagulation. Clearly, the ability to control or stop neovascularization would be helpful in the management of these diseases.
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Radiation Therapy for Age-Related Macular Degeneration
JAMA: The Journal of the American Medical Association, 1997Co-Authors: Paul T. FingerAbstract:To the Editor. —While I commend Mr Skolnick 1 for covering this promising experimental treatment option for "wet" (neovascular) Macular Degeneration, it was disturbing that only radiation oncologists were quoted with respect to the results of treatment. Since ophthalmologists were (or should have been) required to evaluate each patient's eligibility, measure visual acuity, and determine funduscopic changes, why were they conspicuously absent in the article? As an ophthalmologist and specialist in ophthalmic radiation therapy, I have determined eligibility, supervised irradiation, and provided follow-up care for 300 patients with wet Macular Degeneration. I have determined that each patient had the wet form of Macular Degeneration, determined that each patient should be referred for radiation therapy consultation, treatment, or both, and followed up with each closely for evidence of both adverse effects and response to treatment. During the last 4 years, we have reviewed our charts periodically and noted few adverse effects
Fu Chun-lan - One of the best experts on this subject based on the ideXlab platform.
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Analysis of Radiotherapy of Senile Macular Degeneration
Henan Journal of Oncology, 2003Co-Authors: Fu Chun-lanAbstract:Objective To investigate the clinical significance of radiotherapy of senile Macular Degeneration.Methods Forey-six eyes of thirty-eight patients with senile Macular Degeneration were retrospectively analyzed.Radiotherapy was given with 60Co.The radiation dose ranged from 18Gy to 24Gy by conventional fractionation.Results Eyesight changed with reduction,stableness,improvement was reference standard of an efficacious treatment.Eyesight change for reduction,stableness,improvement was 2.2%(1/46),21.7%(10/46),76%(35/46),respectively.Conclusion Radiotherapy is a new method for senile Macular Degeneration patients,and makes it advisable in extensive clinical practice.
Vjk Menon - One of the best experts on this subject based on the ideXlab platform.
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Age-related Macular Degeneration: an overview and update
Therapy, 2006Co-Authors: Pl Lip, Vjk MenonAbstract:Age-related Macular Degeneration affects a growing number of patients in the elderly population every year, with a profound effect on their lifestyle as a result of visual disability. Visual rehabilitation plays a key role in maximizing patients' remaining vision, confidence and independence. In recent years, there has been a tremendous advance in treatment for wet age-related Macular Degeneration, and an even wider range of antiangiogenic agents should be available to improve disease prognosis in the near future. This paper also gives an overview of the natural course of age-related Macular Degeneration, its diagnosis, investigations and past/present treatment options.
Norbert Bornfeld - One of the best experts on this subject based on the ideXlab platform.
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The treatment of wet age-related Macular Degeneration.
Deutsches Arzteblatt international, 2009Co-Authors: Antonia M. Joussen, Norbert BornfeldAbstract:The use of vascular endothelial growth factor (VEGF) inhibitors to treat age-related Macular Degeneration has been widely covered in the press and has generated much public discussion, in which highly subjective points of view are often expressed (1). This article is a selective review of the literature based on a PubMed search for the terms "age-related Macular Degeneration" and "therapy" as well as on the current health policy debate over this matter in Germany (e1). Age-related Macular Degeneration is the most common cause of blindness in the elderly (2, e2). Although only a minority of patients with late age-related Macular Degeneration (AMD) lose enough visual acuity to qualify as legally blind (see table 1) (e3), most patients with advanced AMD have only poor residual vision and thus meet the definition of "severe visual impairment" currently in use in Germany (table 1). Exudative, or "wet," AMD is a late form of AMD (as distinguished from atrophic, so-called dry, AMD) and is responsible for 60% to 80% of all cases of blindness due to AMD. The prevalence of advanced AMD is estimated at 1.47% in the United States population (e4). An extrapolation to Europe yields a prevalence figure of 3.5% among persons over age 65 (3). Table 1 Definitions in age-related Macular Degeneration
