眼球后极的一些营养不良疾病与慢性炎症和病毒传播有关(综述)

Sergej A. Ignatiev, V. A. Pavlov, Sergej P. Kazakov
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摘要

医学和社会对老年性黄斑变性(AMD)和眼后极其他退行性疾病问题的紧迫性,首先是由于直到现在这种疾病是无法治愈的,而且其特点是一个渐进的过程。黄斑变性是导致视力丧失的最常见原因之一。在俄罗斯,AMD的发病率是每1000人中有15例。在原发性AMD致残的结构中,工作年龄的患者占21%,由于老年人群的比例有明显的上升趋势,因此AMD的发病率逐年上升。在过去的十年中,视网膜的病理过程已经成为一个全球性的问题,在不同年龄段的人群中,这组疾病包括大量不同的视网膜营养不良症。在过去几年中,有一种明显的趋势是这类疾病的死灰复燃。这些变化是视力丧失的最常见原因,尤其是渗出形式的老年性黄斑变性(AMD)。最近的研究表明,这种形式的AMD不仅与衰老、血管壁薄弱和自由基氧化有关,而且与非特异性免疫刺激以及巨细胞病毒感染、其他病毒和微生物作为触发剂的潜在作用有关。毫不奇怪,内皮细胞的慢性感染导致巨噬细胞被吸引到炎症区域,它们的粘附和抗炎细胞因子的合成,最终刺激绒毛膜新生血管(CNV)的形成或激活。
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Some dystrophic diseases of the posterior pole of the eye associated with chronic inflammation and viral transmission (review)
The medical and social urgency of the problem of age-related macular degeneration (AMD) and other degenerative diseases of the posterior pole of the eye is explained, first of all, by the fact that until now the disease is incurable and is characterized by a progressive course. AMD is one of the most common causes of vision loss. The incidence of AMD in Russia is 15 cases per 1,000 people. In the structure of primary AMD disability, patients of working age account for 21%, and due to the fact that there is a clear trend toward an increasing share of the elderly population, there is an annual increase in the incidence of AMD. In the last decade, pathological processes of the retina have become a global problem among people of different age categories, and this group of diseases includes a large number of different retinal dystrophies. In the last few years, there has been a clear trend towards the rejuvenation of such diseases. These changes are the most common causes of vision loss, especially the exudative form of age-related macular degeneration (AMD). Recent studies have shown that this form of AMD is associated not only with aging, vascular wall weakness and free-radical oxidation, but also with nonspecific immunostimulation and the potential role of cytomegalovirus infection, other viruses and microorganisms as a trigger agent. Not surprisingly, chronic infection of endothelial cells leads to the attraction of macrophages to the area of inflammation, their adhesion and synthesis of anti-inflammatory cytokines, which eventually stimulates the formation or activation of chorioidal neovascularization (CNV).
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