The Ocular Angiogenesis Group is a research group within the Academic Medical Center (Amsterdam, The Netherlands). Our research is focused on fundamental aspects of retinal blood vessel dysfunction in the context of diabetes and age-related retinal disease.
Diabetic retinopathy (DR) is a major complication of diabetes and a leading cause of blindness. Despite recent progress in understanding the pathogenesis of DR, including the role of growth factors herein, the disease is still neither preventable nor curable. DR is a multifactorial disease, with stepwise progression from a pre-clinical stage (PCDR) characterized by basement membrane thickening, pericyte and endothelial cell apoptosis and breakdown of the blood-retinal barrier leading to diffusely increased vascular permeability, to an early clinical stage (NPDR) with visual loss from gross vascular leakage, retinal vascular occlusion and ischemia, which eventually cause the clinical manifestations of the late clinical stage (PDR): vision-threatening vascular leakage and macular edema, and pre-retinal neovascularization which may ultimately lead to fibrosis and scarring. PDR is potentially the most serious of the ocular complications of diabetes. PDR can disrupt an already compromised macular function through traction and can cause tractional retinal detachment and total blindness.
Age-related macular degeneration (AMD) is a progressive, degenerative disease of the central retina culminating in severe visual loss. In The Netherlands, AMD is the leading cause of blindness in people aged >50 years. In the advanced stage of neovascular (“wet”) AMD, abnormal growth of blood vessels in the central part of the retina results in hemorrhage, fluid leakage, scarring, and fibrosis, and leads to loss of central vision and ultimately to legal blindness if left untreated. Because the Dutch population is rapidly aging, the number of affected individuals with AMD is predicted to increase over the next decade.
In the past twelf years, we have identified several important cellular and molecular mechanisms in DR and AMD, based on our findings in several experimental models and analysis of patient material, which helped us to develop a better understanding of the key mechanisms involved in these diseases.