Emerging therapeutic strategies for unmet need in neovascular age-related macular degeneration

Abstract

Neovascular age-related macular degeneration (nAMD) is a major cause of visual impairment and blindness. Anti-vascular endothelial growth factor (VEGF) agents, such as ranibizumab, bevacizumab, aflibercept, brolucizumab and faricimab have revolutionized the clinical management of nAMD. However, there remains an unmet clinical need for new and improved therapies for nAMD, since many patients do not respond optimally, may lose response over time or exhibit sub-optimal durability, impacting on real world effectiveness. Evidence is emerging that targeting VEGF-A alone, as most agents have done until recently, may be insufficient and agents that target multiple pathways (e.g., aflibercept, faricimab and others in development) may be more efficacious. This article reviews issues and limitations that have arisen from the use of existing anti-VEGF agents, and argues that the future may lie in multi-targeted therapies including alternative agents and modalities that target both the VEGF ligand/receptor system as well as other pathways.

Translating discoveries as novel biomarkers and interventions in ophthalmology

“…There is a growing appreciation of the value of these technologies as both markers of disease activity and measures of response to treatment, not just for ophthalmic disease but also disorders affecting other organ systems. There is a growing tide of novel therapeutic approaches in development for ocular diseases [8]. • thorough peer review by experienced researchers in your field…”

DRFNet: a deep radiomic fusion network for nAMD/PCV differentiation in OCT images

“…Timely accurate diagnosis is crucial as there are significant differences in progression, treatment options, and prognosis between the two conditions. Novel therapeutic targets have been emerging, while intravitreal anti-vascular endothelial growth factor(anti-VEGF) therapies have continued to be used as the first-line treatment for nAMD (Khachigian et al 2023). Current therapeutic avenues of PCV have largely originated from those developed for nAMD, while the effects of additional verteporfin photodynamic therapy for PCV are still controversial (Fenner et al 2022).…”

Multiomic Screening Unravels the Immunometabolic Signatures and Drug Targets of Age-Related Macular Degeneration

“…Conversely, wet AMD is marked by the neovascularization from the choroidal vasculature of the eye, which is thought to be induced by increased expression of hypoxia-driven vascular endothelial growth factor A (VEGF-A), a process called choroidal neovascularization (CNV) (Guymer and Campbell, 2023). Wet AMD causes vision changes through CNV leakage, leading to fluid buildup, hemorrhages and fibrosis in and under the retina, defining it as exudative wAMD (Khachigian et al, 2023).…”