Age-related macular degeneration: current treatment and future options

Abstract

Age-related macular degeneration is the leading cause of visual impairment among older adults in the developed world. Epidemiological studies have revealed a number of genetic, ocular and environmental risk factors for this condition, which can be addressed by disease reduction strategies. We discuss the various treatment options for dry and exudative age-related macular degeneration available and explain how the recommended treatment depends on the exact type, location and extent of the degeneration. Currently, vascular endothelial growth factor (VEGF) inhibition therapy is the best available treatment for exudative age-related macular degeneration but is limited by the need for repeated intravitreal injections. The current treatment regime is being refined through research on optimal treatment frequency and duration and type of anti-VEGF drug. Different modes of drug delivery are being developed and in the future other methods of VEGF inhibition may be used.

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“…Age-related macular degeneration (AMD) is a neurodegenerative disease that leads to deficiencies of retinal pigment epithelium (RPE) and, consequently, reduction in visual function [1]. The RPE is a single layer of cells adjacent to the outer segment of photoreceptor of the retina and Bruch's membrane [2].…”

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“…Age-related macular degeneration (AMD) is a vision-threatening ocular disease affecting the macular region of the retina, retinal pigment epithelium (RPE), Bruch's membrane, and choriocapillaries (1). The disease is typically manifested in two forms: "dry" and "wet."…”

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“…Despite proven to be efficacious [29, 30], concerns have been raised regarding the safety of this drug due to the implications of VEGF in thrombus formation and development of atherosclerotic plaques [28]. To address these concerns, studies were conducted to identify the risk of exposure to cardiovascular events such as thrombosis, hypertension, and haemorrhage.…”

“…In addition, it is less affinity matured than ranibizumab but binds to more isoforms of VEGF [28]. Through large clinical trials, bevacizumab has demonstrated similar efficacy and safety results as ranibizumab [32, 33].…”