risk factors for age-related maculopathy年龄相关性黄斑病变的危险因素.pdf

Hindawi Publishing Corporation Journal of Ophthalmology Volume 2009, Article ID 360764, 39 pages doi:10.1155/2009/360764 Review Article Risk Factors for Age-Related Maculopathy Paul P. Connell,1 Pearse A. Keane,1 Evelyn C. O’Neill,1 Rasha W. Altaie,1 Edward Loane,1 Kumari Neelam,1 John M. Nolan,2 and Stephen Beatty1, 2 1 Waterford Regional Hospital, Dunmore Road, Waterford, Ireland 2 Macular Pigment Research Group, Waterford Institute of Technology, Waterford, Ireland Correspondence should be addressed to Paul P. Connell, drpaulconnell@ Received 11 February 2009; Accepted 8 July 2009 Recommended by Ian Grierson Age-related maculopathy (ARM) is the leading cause of blindness in the elderly. Although beneficial therapeutic strategies have recently begun to emerge, much remains unclear regarding the etiopathogenesis of this disorder. Epidemiologic studies have enhanced our understanding of ARM, but the data, often conflicting, has led to difficulties with drawing firm conclusions with respect to risk for this condition. As a consequence, we saw a need to assimilate the published findings with respect to risk factors for ARM, through a review of the literature appraising results from published cross-sectional studies, prospective cohort studies, case series, and case control studies investigating risk for this condition. Our review shows that, to date, and across a spectrum of epidemiologic study designs, only age, cigarette smoking, and family history of ARM have been consistently demonstrated to represent risk for this condition. In addition, genetic studies have recently implicated many genes in the pathogenesis of age- related maculopathy, including Complement Factor H, PLEKHA 1, and LOC387715/HTRA1, demonstrating that environmental and genetic factors are importa