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Abstract
This thesis analyzes the significance of morphological changes in the retinal pigment epithelium (RPE) in the development of age-related macular degeneration (AMD). The RPE plays an essential role in maintaining the metabolic and structural stability of photoreceptors, phagocytosing their outer segments, supporting retinoid metabolism, regulating ion and fluid transport, and preserving the integrity of the outer blood-retinal barrier. During the development of AMD, RPE cells may undergo morphological changes such as heterogeneity in shape and size, uneven pigmentation, lipofuscin accumulation, vacuolization, cellular migration, disorganization, and atrophy. The relationship of these changes with structural alterations in Bruch’s membrane, drusen formation, and photoreceptor degeneration is of significant importance in the morphological progression of the disease. The progression of RPE atrophy is associated with disruption of outer retinal homeostasis and secondary damage to photoreceptors. Therefore, comprehensive assessment of the morphological condition of the retinal pigment epithelium is of important scientific significance for understanding the mechanisms underlying AMD progression, characterizing structural changes, and identifying morphological criteria for disease progression.
References
1. Somasundaran S., Constable I.J., Mellough C.B., Carvalho L.S. Retinal pigment epithelium and age-related macular degeneration: a review of major disease mechanisms // Clinical & Experimental Ophthalmology. – 2020. – Vol. 48, No. 8. – P. 1043–1056. DOI: 10.1111/ceo.13834. (PubMed)
2. Fleckenstein M., Keenan T.D.L., Guymer R.H. et al. Age-related macular degeneration // Nature Reviews Disease Primers. – 2021. – Vol. 7. – Article 31. DOI: 10.1038/s41572-021-00265-2. (PubMed Central (PMC))
3. Bhutto I., Lutty G. Understanding age-related macular degeneration (AMD): relationships between the photoreceptor/retinal pigment epithelium/Bruch’s membrane/choriocapillaris complex // Molecular Aspects of Medicine. – 2012. – Vol. 33, No. 4. – P. 295–317. DOI: 10.1016/j.mam.2012.04.005. (PubMed Central (PMC))
4. Bonilha V.L. Age and disease-related structural changes in the retinal pigment epithelium // Clinical Ophthalmology. – 2008. – Vol. 2, No. 2. – P. 413–424. DOI: 10.2147/OPTH.S2151. (PubMed Central (PMC))
5. Zanzottera E.C., Messinger J.D., Ach T., Smith R.T., Freund K.B., Curcio C.A. The Project MACULA Retinal Pigment Epithelium Grading System for Histology and Optical Coherence Tomography in Age-Related Macular Degeneration // Investigative Ophthalmology & Visual Science. – 2015. – Vol. 56, No. 5. – P. 3253–3268. DOI: 10.1167/iovs.15-16431. (PubMed)
6. Green W.R., Key S.N. Senile macular degeneration: a histopathologic study // Transactions of the American Ophthalmological Society. – 1977. – Vol. 75. – P. 180–254.
7. Young R.W. Pathophysiology of age-related macular degeneration // Survey of Ophthalmology. – 1987. – Vol. 31, No. 5. – P. 291–306. DOI: 10.1016/0039-6257(87)90115-9.
8. Strauss O. The retinal pigment epithelium in visual function // Physiological Reviews. – 2005. – Vol. 85, No. 3. – P. 845–881. DOI: 10.1152/physrev.00021.2004.
9. Ambati J., Fowler B.J. Mechanisms of age-related macular degeneration // Neuron. – 2012. – Vol. 75, No. 1. – P. 26–39. DOI: 10.1016/j.neuron.2012.06.018.
10. Ferris F.L., Wilkinson C.P., Bird A. et al. Clinical classification of age-related macular degeneration // Ophthalmology. – 2013. – Vol. 120, No. 4. – P. 844–851. DOI: 10.1016/j.ophtha.2012.10.036.
11. Sparrow J.R., Hicks D., Hamel C.P. The retinal pigment epithelium in health and disease // Current Molecular Medicine. – 2010. – Vol. 10, No. 9. – P. 802–823.
12. Wong W.L., Su X., Li X. et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis // The Lancet Global Health. – 2014. – Vol. 2, No. 2. – P. e106–e116. DOI: 10.1016/S2214-109X(13)70145-1.