New risc factors in progression of age-related macular degeneration

Background. Allot of studies investigate the etiology and pathogenesis of age-related macular degeneration (AMD). The exudative form of AMD is the leading cause of irreversible blindness in the elderly. At the same time neurosensory retina detachment in  AMD  has high level of prevalence and severity of comlications but little attention has been paid to explaying the risk factors of retina edema and the possibility of their role on the interstitial fluid accumulation. The investigation of patterns for predicting the risk of retinal detachment is still cosiderable, as this is important for patients selection with high risk of developing retinal detachment of AMD and effective preventive treatment. Purpose: To investigate new risk factors for the progression of age-related macular degeneration. Materials and methods. The prospective study included  37 patients (67 eyes) with the exudative form of AMD (Category 4 according to the AREDS). 21 (56.8%) patients had exudative detachment of neurosensory retina. The ophthalmologic examination included anamnesis, visometry, tonometry, biomicroscopy, ophthalmoscopy and optical coherence tomography. ATP, ADP, adenosine, platelet-activating factor (PAF), adrenaline and isadrin were used to study the functional activity of platelet receptors. The evaluation of platelet aggregation was carried out by a turbidimetric method. Methods of pair correlation analysis and multiple linear regression models were used  to analyse the relationship between the values of individual agonists the retinal detachment.  Results. After analysis of nine items, three of which were found to be significantly associated with serous detachment of neurosensory retina, including the activity of PAF receptors, adenosine A2A receptors and α2-adrenoreceptors. The prognosis of the cases of this complication in the general cohort of patients with exudative AMD turned out to be positive in 87.5%. Conclusions. Correlation between the development of exudative detachment of neurosensory retina and the functional state of Pl can be used in the selection for preventive treatment of patients with retinal detachment in AMD.