%0 Journal Article
%T Current Treatment Limitations in Age-Related Macular Degeneration and Future Approaches Based on Cell Therapy and Tissue Engineering
%A P. Fern¨¢ndez-Robredo
%A A. Sancho
%A S. Johnen
%A S. Recalde
%A N. Gama
%A G. Thumann
%A J. Groll
%A A. Garc¨ªa-Layana
%J Journal of Ophthalmology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/510285
%X Age-related macular degeneration (AMD) is the leading cause of blindness in the Western world. With an ageing population, it is anticipated that the number of AMD cases will increase dramatically, making a solution to this debilitating disease an urgent requirement for the socioeconomic future of the European Union and worldwide. The present paper reviews the limitations of the current therapies as well as the socioeconomic impact of the AMD. There is currently no cure available for AMD, and even palliative treatments are rare. Treatment options show several side effects, are of high cost, and only treat the consequence, not the cause of the pathology. For that reason, many options involving cell therapy mainly based on retinal and iris pigment epithelium cells as well as stem cells are being tested. Moreover, tissue engineering strategies to design and manufacture scaffolds to mimic Bruch¡¯s membrane are very diverse and under investigation. Both alternative therapies are aimed to prevent and/or cure AMD and are reviewed herein. 1. Age-Related Macular Degeneration: Socioeconomic Burden and Limitations of Current Therapies 1.1. General Introduction Age-related macular degeneration (AMD) is one of the leading causes of vision loss and the most common cause (almost epidemic) of blindness in industrialized countries. It is the first source of legal blindness (visual acuity < 20/200) in Europe and mainly affects people over the age of 50 affecting about 30 million people worldwide. The dramatic loss of autonomy and life quality associated with AMD [1, 2] leads to increased costs for healthcare and long-term care. AMD is multifactorial but clearly age-related pathology. The number of affected people is expected to double by the year 2020 as a result of ageing of the world¡¯s population. Even, in developed countries, AMD is gaining attention due to increased life expectancy and improved visual care facilities [3]. AMD is an inflammatory chronic progressive eye disease with damage to retinal pigment epithelium (RPE) cells in its early stage, while late stage has two distinct forms: the slowly progressing ¡°nonvascular¡± and the rapidly progressing ¡°neovascular¡± AMD [4]. However, both forms eventually lead to blindness [5] through degeneration of retinal pigment epithelium (RPE) and posterior photoreceptor (PR) cells. Moreover, with age, the metabolic activities of RPE cells decrease leading to deposition of debris on and in BM and decreased turnover and degradation of the extracellular matrix (ECM) resulting in altered filtration of nutrients and metabolic wastes
%U http://www.hindawi.com/journals/joph/2014/510285/