Expanding our knowledge of dry AMD


Professor Scott Cousins explains how we can use our knowledge of drusen formation to find new ways to combat dry age-related macular degeneration.

Key Points

Drusen development: the four theories

Currently, there are four key theories for explaining drusen formation. These are:

The role of inflammation

Our understanding of the disease has evolved rapidly in recent years. "I think that the greatest breakthrough in understanding the pathogenesis of drusen that we have had in the last five to seven years is this idea that inflammation, in various forms, is a major contributor to the disease; that the innate immune system plays a major role," asserted Professor Cousins. "In the last three years, there has been a lot of data published that show that the genetic impetus of AMD is found among the complement inhibitors in the complement system; specifically, Complement Factor H is the most important susceptibility gene.

"My laboratory, among others, has also looked at the role of one of the circulating white cells: the monocyte. We already know that its tissue equivalent, the macrophage, has a major role to play in wet AMD, but we're now learning it plays a role in dry AMD as well, and so we're exploring what this may mean for the development of the disease," Professor Cousins explained.

"The most recent breakthrough in our understanding was published in a New England Journal of Medicine article,"1 Professor Cousins continued. As previously reported by Ophthalmology Times Europe,2 this study examined the role of a mutation of the toll-like receptor 3 (TLR3) gene. TLR3 is a protein that alerts the immune system to infections, and a mutated form of the TLR3 gene, expressing leucine instead of phenylalanine, was shown to be protective against geographic atrophy, most likely by suppressing the death of RPE cells.

Related Videos
 Allen Ho, MD, presented a paper on the 12 month results of a mutation agnostic optogenetic programme for patients with severe vision loss from retinitis pigmentosa
ARVO 2024: President-elect SriniVas Sadda, MD, speaks with David Hutton of Ophthalmology Times
Paul Kayne, PhD, on assessing melanocortin receptors in the ocular space
Giulia Corradetti, MD, discusses her presentation "Functional Microperimetric Correlates of OCT Structures Features in Intermediate AMD"
At this year's ARVO meeting, Paolo Silva, MD, presented data on Protocol AA on behalf of the DRCR Retina Network
Baruch Kuppermann, MD, PhD
At this year's ARVO meeting, Qinqin Zhang, PhD, presented a poster titled "A unified deep learning model for geographic atrophy segmentation: Adaptable to SS-OCT and SD-OCT data with multiple scan patterns."
Ash Abbey, MD, shares 36-month data from the GALE study of pegcetacoplan
© 2024 MJH Life Sciences

All rights reserved.