The Therapeutic Effects Of Yin-Enriching And Eye-Brightening Pill On Age-Related Macular Degeneration And Its Therapeutic Mechanisms

Objective: To investigate the therapeutic effects of Yin-Enriching and Eye-Brightening Pill (YEP) on rats with retinal phototrauma and on patients with age-related macular degeneration and its therapeutic mechanisms.Methods: Seventy rats were randomly divided into 7 groups, with 6 groups prepared as the models of phototrauma at first and another group taken as blank controlling one among these groups. Then, the animals in the treatment and controlling groups were treated with YEP and control agent respectively for 15 days during the period of experiment. Following this, the retinal tissues were taken to investigate the structural changes with light and electronic microscopes, to determine the free radical indexes and to test the expressive activities of bcl-2 and p53 genes with immunohistochemical method. Meanwhile, the therapeutic effects of YEP were also studied in patients with ARMD of the syndrome Liver-Kidney Yin deficiency.Results: Morphological studies showed that significant changes were present at both the cellular level and sub-cellular level in the model group without any intervention procedures given, including the obscured tissue structure of the retina accompanied with cell necrosis, karyorrhexis, and swelling, karyopyknosis and mitochondria vacuolar degeneration in the photoreceptor, bipolar and ganglion cells. These findings indicated that model preparation by light damaging to the retina was successful. In contrast, animalsin the treatment groups with YEP showed significantly improved ultrastructure of the retina, meaning that their retinal lesions were repaired largely and that the morphological structure of the retina was brought to normal gradually. In the same time, the activities of SOD and GSH-PX were significantly increased in these treated animals and that of MDA was largely decreased, suggesting that YEP held significant effects on the production of lipid peroxide and the clearance of free radical. Furthermore, this preparation could upregulate the expression of bcl-2 gene and downregulate the expression of p53 gene to induce an inhibitory effect on apoptosis of the retinal cells. On the other hand, clinical observation also showed that YEP was very effective for the treatment of patients with ARMD, with the total effective rates being 81.4%, 67.53% and 64.93% for the improvements of general symptoms, visual acuity and visual field respectively.Conclusions: YEP is effective for the treatment of patients with ARMD. Its therapeutic effects on general symptoms and visual function may be brought out via an improvement of the ultrastrutural lesions of the retina, clearance of free radical and changes in the expressive activities of apoptosis-related genes, i.e. bcl-2 and p53, to inhibit apoptosis taking place in the retinal cells.