Chapter

Retinal Degeneration

pp 3-14

Lipofuscin in Aged and AMD Eyes

  • C. Kathleen DoreyAffiliated withSchepens Eye Research Institute, Biochemistry and Cell Biology Macular Degeneration Research CenterDepartment of Ophthalmology, Harvard Medical School
  • , Giovanni StaurenghiAffiliated withSchepens Eye Research Institute, Biochemistry and Cell Biology Macular Degeneration Research CenterDepartment of Ophthalmology, Harvard Medical SchoolIstituto di Scienze Biomediche, Clinica Oculistica Universitâ degli Studi di Milano
  • , Francois C. DeloriAffiliated withSchepens Eye Research Institute, Biomedical Physics and Macular Degeneration Research CenterDepartment of Ophthalmology, Harvard Medical School

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Abstract

AMD is a progressive degeneration of the retina which preferentially and initially affects the macula but ultimately involves the fovea (1). The leading cause of visual impairment for individuals over 65, it will affect an estimated 8 million Americans in the next 20 years (2). The majority of these will experience a gradual erosion of vision due to progressive atrophy of photoreceptors—causing decreased visual acuity, loss of color vision and tunnel vision; some will be legally blind (3). About 90% of legal blindness in AMD is due to exudative AMD, characterized by serous detachment of the retina, retinal pigment epithelial detachment and tears, aggressive growth of new blood vessels from the choroid into the subretinal space, and disciform scaring. Fortunately, only 5–10% of patients will develop exudative AMD (4,5) While laser photocoagulation can delay and/or reduce the consequent visual loss, the prognosis remains grim—most will be blind (6). Presently, there is no medical treatment to stop or slow the course of this disease nor any known prevention.