Review of Role of Telomerase in the Management of Age-related Macular Degeneration

Abstract

Age related macular degeneration is degenerative disorder, which is more prevalent in the Western, developed countries but can become a major threat in India as well. It affects the macula and leads to the senescence of retinal pigment epithelium. Most commonly affected is the central vision as macula is involved in central vision. On Optical Coherence Tomography (OCT) reduction in retinal epithelium can be seen along with accumulation of blood in the sub retinal space due to haemorrhage in the wet type of ARMD. It is a multifactorial disease and some of the major risk factors of this disease include sunlight exposure i.e. production of large amounts of reactive oxygen species (ROS), smoking, blue iris etc. It is more commonly seen in females and in Caucasians. It is of two major types which include the dry type (85%) and the remaining wet type. Wet type is characterised by neovascularisation whereas the dry type shown the presence of drusens and hyperpigmentation of the retina on examination. Clinical features of this disease include gradual loss of vision, but in wet type due to fragile vessels there occurs haemorrhage which can lead to sudden loss of vision. ARMD can be prevented by introduction of telomerase in the treatment line. Telomerases help in increasing the life span of RPE, thereby delaying the senescence of the retinal cells. Other treatment modalities also include the administration of lutein, xeathanthine, various antioxidants and anti-VEGF (vascular endothelium growth factor) medication. All these measures together can help in reducing the number of cases of ARMD and providing a better vision to the older population to increase the quality of life.