Evidence map›Paper›PMID 22542780›Full record

ReviewMolecular aspects of medicine2012

Understanding age-related macular degeneration (AMD): relationships between the photoreceptor/retinal pigment epithelium/Bruch's membrane/choriocapillaris complex.

Imran Bhutto, Gerard Lutty

Open access · greenAbstract readReview
In one paragraph

Review in Molecular aspects of medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 563 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
563citing papers in PubMed, 2 pooled it
34.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

563 citing papers in PubMed, 2 syntheses or guidelines pooled it, 977 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. En face visualization of the outer choroidal vessels in regions with geographic atrophy.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
    Article
  4. Article
  5. Article
  6. Bidirectional Retro mode differential imaging improves drusen boundary depiction in early and intermediate AMD: a pilot study.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
    Article
  7. Article
  8. Review
  9. Stress Inference in Retinal Pigment Epithelium in C57BL/6J Mouse.Investigative ophthalmology & visual science · 2026
    Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Choriocapillaris flow deficits and choroidal vascular index in the fellow eye of patients with central serous chorioretinopathy.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
    Article
  16. Article
  17. An siRNA targetingMolecular therapy. Nucleic acids · 2026
    Article
  18. Article
  19. A literature review of macular holes in age-related macular degeneration: insights into the pathogenesis, prognosis and surgical outcomes.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
    Review
  20. Article

503 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Imran BhuttoWilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD 21287-9115, USA.
Gerard Lutty
Johns Hopkins Hospital · US

Funding

Wilmer Core Grant for Vision ResearchP30EY001765 · NEI · JOHNS HOPKINS UNIVERSITY · PI Jiang Qian · 1985 to 2026
$22.1M
Inflammatory cells of choroid: a therapeutic target in AMD.R01EY016151 · NEI · JOHNS HOPKINS UNIVERSITY · PI EDWARDS, MALIA MICHELLE · 2006 to 2024
$8.0M
Vasculogenesis and hyperoxia in the developing retina.R01EY009357 · NEI · JOHNS HOPKINS UNIVERSITY · PI LUTTY, GERARD ANTHONY · 1993 to 2014
$5.3M
NEI NIH HHS EY016151NEI NIH HHS EY01765NEI NIH HHS EY09357NEI NIH HHS P30 EY001765NEI NIH HHS R01 EY009357NEI NIH HHS R01 EY016151
6 · The paper itself

Abstract

There is a mutualistic symbiotic relationship between the components of the photoreceptor/retinal pigment epithelium (RPE)/Bruch's membrane (BrMb)/choriocapillaris (CC) complex that is lost in AMD. Which component in the photoreceptor/RPE/BrMb/CC complex is affected first appears to depend on the type of AMD. In atrophic AMD (~85-90% of cases), it appears that large confluent drusen formation and hyperpigmentation (presumably dysfunction in RPE) are the initial insult and the resorption of these drusen and loss of RPE (hypopigmentation) can be predictive for progression of geographic atrophy (GA). The death and dysfunction of photoreceptors and CC appear to be secondary events to loss in RPE. In neovascular AMD (~10-15% of cases), the loss of choroidal vasculature may be the initial insult to the complex. Loss of CC with an intact RPE monolayer in wet AMD has been observed. This may be due to reduction in blood supply because of large vessel stenosis. Furthermore, the environment of the CC, basement membrane and intercapillary septa, is a proinflammatory milieu with accumulation of complement components as well as proinflammatory molecules like CRP during AMD. In this toxic milieu, CC die or become dysfunction making adjacent RPE hypoxic. These hypoxic cells then produce angiogenic substances like VEGF that stimulate growth of new vessels from CC, resulting in choroidal neovascularization (CNV). The loss of CC might also be a stimulus for drusen formation since the disposal system for retinal debris and exocytosed material from RPE would be limited. Ultimately, the photoreceptors die of lack of nutrients, leakage of serum components from the neovascularization, and scar formation. Therefore, the mutualistic symbiotic relationship within the photoreceptor/RPE/BrMb/CC complex is lost in both forms of AMD. Loss of this functionally integrated relationship results in death and dysfunction of all of the components in the complex.

Indexed as

AnimalsBruch MembraneChoroidHumansInflammationMacular DegenerationPhotoreceptor CellsRetinal Pigment Epithelium

Identifiers

PMID22542780
PMCPMC3392421
OpenAlexW2007014682

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.