GEOGRAPHIC ATROPHY IN PATIENTS WITH DRY AGE-RELATED MACULAR DEGENERATION: CURRENT PROBLEMS OF PATHOGENESIS AND PROSPECTS FOR PROGRESSION DIAGNOSTICS
About the author:
Kovalchuk Kh. V.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Geographic atrophy (GA) of the retinal pigment epithelium (RPE) of the retina is a severe complication of age-related macular degeneration (AMD), which leads to progressive and irreversible loss of visual function. Aim of this study: to investigate new links of pathogenesis and perspectives of diagnostics of geographical atrophy progression in patients with dry form of age-related macular degeneration. Object and methods. The study was prospective and included 74 patients (136 eyes) with early and intermediate stages of dry form of AMD in accordance with the present study. Ophthalmic examination included visual acuity, visual fields, tonometry, gonioscopy, biomicroscopy, ophthalmoscopy, optical coherence tomography. To study the functional activity of platelets (PL) receptors, agonists were used: ATP, ADP, adenosine, TC activation factor (FAT), adrenaline and isadrine. Estimation of PL aggregation was performed by the turbidimetric method. Results. Comparison of PL receptors reactivity in patients with early stage dry form of AMD showed that the development of dystrophic changes was characterized by an increase in the reactivity of purine P2Y- and P2Xreceptors (p <0.01), α2-adrenoceptors (p <0.01) and FAT receptors (p <0.01). The decrease in the activity of A2A receptors and β2-adrenoceptors (p <0.001) reflected the lack of efficiency of existing vasodilator and cytoprotective mechanisms. In patients with intermediate stage of dry form of AMD, in which there were multiple medium-sized druzen associated with GA, preservation of hyperreactivity of purine receptors (P2Y- and P2X-), α2-adrenoceptors and FAT PL receptors; ADP provided increased PL aggregation (p <0.01); the PL response to adenosine and isadrine decreased (p <0.001). Conclusions. Thus, the reactivity of PL receptors reflects the influence of the pathogenetic factors of AMD, and therefore can be used to predict the risk of developing GA in such patients.
age-related macular degeneration, geographical atrophy, retinal pigment epithelium, platelet receptors, pathogenesis, diagnostics.
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 4 Part 2 (154), 2019 year, 107-111 pages, index UDK 617.736-007.17-053-092.12