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Mathematics to improve the treatment of macular degeneration

The age-related macular degeneration (AMD) It is a degenerative disease of the macula, the central area of ​​the retina. It currently has no cure and is characterized by a gradual loss of central vision, being the leading cause of blindness in people over 65 years of age in developed countries.

In Spain it is estimated that AMD affects around 800,000 people. Globally, there would be about 196 million people affected and it is estimated that they will rise to 288 million in the year 2040.

There are two types of AMD: dry or atrophic phase, which is usually the initial and most common, which progresses slowly and progressively; and the acute phase, called as wet or exudative, which is less frequent but has a worse prognosis at the visual level.

Researchers from the Carlos III University of Madrid have created a mathematical simulation that recreates the progression of age-related macular degeneration, which can help to better understand its origin and evolution

In the latter there is a angiogenesis under the retina, an abnormal growth of very fragile blood vessels that can leak fluid and bleed, which can cause the destruction of photoreceptor cells necessary for vision.

In this context, scientists from the Carlos III University of Madrid (UC3M) have created a simulation of a computational model of this angiogenesis (the spread of blood capillaries), taking into account how it occurs in the eye. The study is published in the journal Biomedicines.

“In this case, what happens is that, with age, a barrier (called Bruch’s membrane) that separates the capillaries from the inner part of the retina becomes less permeable and, therefore, oxygen does not reach nor sufficient nutrients to the photoreceptors ”, explains the co-author Luis L. Bonilla, from the “Gregorio Millán Barbany” University Institute on Modeling and Simulation in Fluid Dynamics, Nanoscience and Industrial Mathematics at UC3M.

“Then,” he continues, “they emit a signal (called growth factor) that spreads, passes where the blood vessels are and causes this angiogenesis to appear, which is what causes the disease.”

Model to better understand the disease

In practice, relatively little is known about the evolution and appearance of this disease and the researchers hope that with this mathematical modeling they can better understand how this pathology is generated, how long it takes to progress and if there is any way to stop it with the therapies that are being used. know today.

“The model has several parameters that characterize the progression of the disease. One can change them and predict how the disease is going to develop depending on some values ​​or others, so it can be used to control how the process occurs, ”explains Bonilla.

The results suggest that therapies based on decreasing growth factors and proteins crucial for angiogenesis may temporarily slow down the disease, while those that improve cell adhesion could be more effective in the long term.

The numerical simulations of the model suggest that the therapies based on decreasing growth factors and proteins crucial for angiogenesis can temporarily slow down the disease, while other therapies based on improving cell adhesion could be more effective in the long term.

In addition, this model could be used to investigate other diseases of the retina, scientists indicate, such as diabetic retinopathy or that associated with prematurity of babies, since in these cases these pathologies are also produced by an abnormal growth of blood vessels.

Reference:

R. Vega, M. Carretero, LL Bonilla. “Anomalous Angiogenesis in Retina”. Biomedicines, 2021.

Rights: Creative Commons.

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