title: [Non-pharmacologic therapy of age-related macular degeneration, based on the etiopathogenesis of the disease].
abstract: It has a great therapeutic significance that the disorder of the vascular endothelium, which supplies the affected ocular structures, plays a major role in the development of age-related macular degeneration. Chronic inflammation is closely linked to diseases associated with endothelial dysfuncition and age-related macular degeneration is accompanied by a general inflammatory response. The vascular wall including those in chorioids may be activated by several repeated and/or prolonged mechanical, physical, chemical, microbiological, immunologic and genetic factors causing a protracted host defence response with a consequent vascular damage, which leads to age-related macular degeneration. Based on this concept, age-related macular degeneration is a local manifestation of the systemic vascular disease. This recognition should have therapeutic implications because restoration of endothelial dysfunction can stabilize the condition of chronic vascular disease including age-related macular degeneration, as well. Restoration of endothelial dysfunction by non-pharmacological or pharmacological interventions may prevent the development or improve endothelial dysfunction resulting in prevention or improvement of age-related macular degeneration. Non-pharmacological interventions which may have beneficial effect in endothelial dysfunction include (1) smoking cessation; (2) reduction of increased body weight; (3) adequate physical activity; (4) appropriate diet (a) proper dose of flavonoids, polyphenols and kurcumin; (b) omega-3 long-chain polyunsaturated fatty acids: docosahexaenoic acid and eicosapentaenoic acid; (c) carotenoids, lutein and zeaxanthins), (d) management of dietary glycemic index, (e) caloric restriction, and (5) elimination of stressful lifestyle. Non-pharmacological interventions should be preferable even if medicaments are also used for the treatment of endothelial dysfunction.
authors.affiliation: Budapest, Körvasút sor 75/B, 1158.
authors.forename: Tamás
authors.initials: T
authors.lastname: Fischer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D031204:Caloric Restriction; D002338:Carotenoids / Q000008:administration & dosage; D003474:Curcumin / Q000008:administration & dosage; D004730:Endothelium, Vascular / Q000473:pathology / Q000503:physiopathology*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005247:Feeding Behavior; D005419:Flavonoids / Q000008:administration & dosage; D038321:Glycemic Index; D006801:Humans; D007249:Inflammation / Q000628:therapy; D014975:Lutein / Q000008:administration & dosage; D008268:Macular Degeneration / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D009043:Motor Activity; D059808:Polyphenols / Q000008:administration & dosage; D040242:Risk Reduction Behavior; D016540:Smoking Cessation; D013315:Stress, Psychological / Q000150:complications / Q000517:prevention & control*; D015431:Weight Loss; D065146:Zeaxanthins / Q000008:administration & dosage
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015525:Fatty Acids, Omega-3; D005419:Flavonoids; D059808:Polyphenols; D065146:Zeaxanthins; D002338:Carotenoids; D003474:Curcumin; D014975:Lutein
keywords: age-related macular degeneration; endotheldiszfunkció; endothelial dysfunction; időskori maculadegeneráció; kockázati tényező; lifestyle modifications; oxidative stress; oxidatív stressz; prevenció; prevention; risk factors; életmód megváltoztatása