Investigations of a Possible Link between Age-Related Macular Degeneration and Atherosclerosis

..................................................................................................................................................... 6 ACKNOWLEDGEMENT ............................................................................................................................... 8 LIST OF FIGURES.......................................................................................................................................... 9 LIST OF TABLES.......................................................................................................................................... 10 ABBREVIATIONS AND SYMBOLS........................................................................................................... 11 CHAPTER 1: INTRODUCTION ................................................................................................................. 16 1.1 Age-related macular degeneration ........................................................................................................ 16 1.1.1 Definition of age-related macular degeneration............................................................................. 16 1.1.2 Diagnosis of age-related macular degeneration ............................................................................. 17 1.1.3 The patho-physiology of AMD...................................................................................................... 20 1.2 Atherosclerosis ...................................................................................................................................... 21 1.2.1 Definition ....................................................................................................................................... 21 1.2.2 Pathogenesis................................................................................................................................... 21 1.3 The link between atherosclerosis and AMD .......................................................................................... 22 1.3.1 Hypotheses..................................................................................................................................... 22 1.3.2 Epidemiological evidence of co-morbidity of Atherosclerosis and AMD ..................................... 23 1.4 Aims and Objectives of this project ....................................................................................................... 32 CHAPTER 2: EXTRACELLULAR MATRIX............................................................................................ 35 2.1 Bruch’s Membrane and the Vascular Intima: Is There a Common Basis for Age-related Changes and Disease? ...................................................................................................................................................... 35 2.1.1 Structural Comparison of the Bruch’s Membrane and the Vascular Wall ..................................... 35 2.1.2 Macroscopic Changes of the BM and the Vascular Wall............................................................... 36 2.1.3 Cell biology of the BM and the vascular wall................................................................................ 37 2.1.4 Lipid accumulation ........................................................................................................................ 39 2.1.5 Matrix dysregulation...................................................................................................................... 40 2.1.6 Matrix metalloproteinases.............................................................................................................. 43 2.1.7 Conclusion from Literature Review............................................................................................... 44 2.2 Serum Elastin Derived Peptides in Age-related Macular Degeneration ............................................... 45 2.2.