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P. Hahn, A.H. Milam, J.L. Dunaief; Human AMD Maculas Contain Increased Chelatable Iron in the RPE and Bruch’s Membrane . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1733.
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Purpose: To investigate whether iron in human retinas is involved in the pathogenesis of age-related macular degeneration (AMD). Methods: The iron levels in post mortem AMD (non-exudative or exudative) and normal maculas were evaluated using the DAB-enhanced Perl’s iron stain, which was quantified by computer-assisted analysis of digital images. Sections treated with the iron chelator deferoxamine were compared with adjacent, non-chelated sections to determine whether any observed iron was chelatable. Results: Compared with normal maculas, AMD maculas had statistically significant increases in total iron in the RPE and Bruch’s membrane. In each eye, a portion of the total iron was chelatable. Iron in some AMD eyes was also detected in neurons of the sensory retina, notably photoreceptors. Iron was present in exudative and both early and late non-exudative AMD maculas in areas of severe pathology and occasionally in histologically unaffected areas. Conclusions: Oxidative stress has been implicated in the pathogenesis of AMD by the Age-Related Eye Disease Study. Increased iron can generate highly reactive hydroxyl radicals via the Fenton reaction and may induce oxidative stress in the macula, leading to AMD. Our finding that iron accumulates in AMD eyes, including early AMD eyes, suggests that iron may be involved in AMD pathogenesis. As the increased iron in these AMD eyes consists in part of a chelatable iron pool, treatment of AMD patients with iron chelators might be considered as a potential therapy.
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