Molecular mechanisms of subretinal fibrosis in age-related macular degeneration

• Clinical implications of subretinal fibrosis in AMD.
• Cellular and extracellular components of subretinal fibrous membranes.
• Growth factors and epithelial–mesenchymal transition in subretinal fibrosis.
• Immune response related to subretinal fibrosis.
• Use of the laser-induced murine model of CNV to study subretinal fibrosis.

Subretinal fibrosis is a result of a wound healing response that follows choroidal neovascularization in neovascular age-related macular degeneration (nAMD). Although anti-vascular endothelial growth factor therapy has become a standard treatment that improves visual acuity in many nAMD patients, unsuccessful treatment outcomes have often been attributed to the progression of subretinal fibrosis. In this review, we summarize the cellular and extracellular components of subretinal fibrous membranes and also discuss the possible molecular mechanisms including the functional involvement of growth factors and the inflammatory response in the process. Moreover, we present an murine animal model of subretinal fibrosis that might facilitate greater understanding of the pathophysiology and the development of novel therapeutic strategies for the inhibition of subretinal fibrosis in nAMD.