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Age-Related Macular Degeneration: Hemodynamic Changes

  • Constantin J. PournarasEmail author
  • Efstratios Mendrinos
  • Jean-Antoine C. Pournaras
Chapter

Core Messages

  • The choriocapillaris layer/Bruch’s membrane/retinal pigment epithelium complex represents a single functional unit; the dysfunction of CC/RPE complex induces the age-related and age macular degeneration (AMD)-related changes.

  • Choroidal vascular density is reduced, and significant vasoconstriction of the CC may occur.

  • In eyes with geographic atrophy, the RPE degenerates first while CC loss is secondary to RPE degeneration. In eyes with exudative AMD, degeneration of the CC layer occurs while RPE is still functional. Resulting ischemia induces production of vasoproliferative factors from the RPE.

  • Choroidal neovascularization (CNV) would result from a misbalance between angiogenic factors, including VEGF, and antiangiogenic factors, such as PEDF, endostatin, and thrombospondin-1. These latter are significantly reduced in AMD.

  • An association exists between systemic vascular diseases and AMD.

  • Choroidal blood flow decreases according to age; it is reduced in patients with AMD...

Keywords

Retinal Pigment Epithelium Retinal Pigment Epithelium Cell Optic Nerve Head Choroidal Neovascularization Geographic Atrophy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Support

This work was supported by FNSRS no 3200-061685.00 (CJP)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Constantin J. Pournaras
    • 1
    Email author
  • Efstratios Mendrinos
    • 1
  • Jean-Antoine C. Pournaras
    • 2
  1. 1.Vitreo-retinal Unit, Department of OphthalmologyGeneva University HospitalsGenevaSwitzerland
  2. 2.Vitreo-retinal Surgery Unit, Department of Ophthalmology, Jules Gonin Eye HospitalUniversity of LausanneLausanneSwitzerland

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