The pathogenesis of choroidal neovascularization in patients with age-related macular degeneration.
Laser photocoagulation and several experimental treatments for choroidal neovascularization (CNV) in patients with age-related macular degeneration attempt to ablate the neovascularization, but do not address underlying angiogenic stimuli. As a result, recurrences are a major problem. Drug treatment to counter the growth of CNV would be a major advance, but its development is impeded by lack of knowledge concerning the stimuli and other molecular signals involved in the pathogenesis of CNV. Herein we explore clues that can be gleaned from clinical, epidemiological, pathological, and experimental data. These suggest that abnormalities of the extracellular matrix of retinal pigmented epithelial (RPE) cells may promote a pro-angiogenic RPE phenotype that contributes to the development of CNV. This provides a general hypothesis that can be tested, but it is also necessary to test hypotheses regarding the specific alterations in gene expression that contribute to CNV. Identification of alterations in gene expression will provide targets for rational design of drug treatment.
Campochiaro
P A
PA
The Departments of Ophthalmology and Neuroscience,The Johns Hopkins University School of Medicine, Baltimore, MD 21287-9277, USA. pcampo@jhmi.edu
Soloway
P
P
Ryan
S J
SJ
Miller
J W
JW
D015862:Choroid Diseases / Q000473:pathology; D020256:Choroidal Neovascularization / Q000150:complications / Q000209:etiology* / Q000473:pathology; D004195:Disease Models, Animal; D016228:Endothelial Growth Factors / Q000502:physiology; D006801:Humans; D008222:Lymphokines / Q000502:physiology; D008268:Macular Degeneration / Q000150:complications* / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000473:pathology; D018919:Neovascularization, Physiologic; D012171:Retinal Vessels / Q000502:physiology; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
D016228:Endothelial Growth Factors; D008222:Lymphokines; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors