Geographic atrophy: clinical impact and emerging treatments

Patel, Hershel R.; Eichenbaum, David

doi:10.3928/23258160-20150101-01

Cited by 24 publications

(27 citation statements)

References 15 publications

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“…Dry AMD accounts for 85%-90% of cases of AMD, and GA is responsible for approximately 20% of all cases of legal blindness. 6 Considerable amelioration of neovascular AMD can be achieved with the use of antiangiogenic agents, photodynamic therapy or thermal laser. [7][8][9] However, no cure is currently available for dry AMD, and the only preventive option is the Age-Related Eye Disease Study (AREDS) formulations, which reduce the risk of AMD progression by 25%-30% over a 5-year period.…”

Section: Introductionmentioning

confidence: 99%

Current therapeutic developments in atrophic age-related macular degeneration

2015

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Age-related macular degeneration (AMD), a degenerative disorder of the central retina, is the leading cause of irreversible blindness in the elderly. The underlying mechanism of the advanced form of dry AMD, also named geographic atrophy (GA) or atrophic AMD, remains unclear. Consequently, no cure is available for dry AMD or GA. The only prevention option currently available is the Age Related Eye Disease Study (AREDS) formulation which has been demonstrated to slow down the progression of dry AMD. This review summarizes recent advances in therapy for dry AMD and GA. Building on the new understanding of the disease and recent technological breakthroughs, numerous ongoing clinical trials have the goal of meeting the need to cure AMD. Therapeutic agents are being developed to target the key features of the disease, including inhibiting the complement pathway and other inflammatory pathways, reducing oxidative stress and protecting retinal pigment epithelial (RPE) cells, inhibiting lipofuscin and visual cycle, regenerating RPE cells from stem cells and restoring choroidal blood flow. Some of these therapeutic options, especially the stem-cell based therapy, hold great promise, which brings great hope for this devastating blinding disease.

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Section: Introductionmentioning

confidence: 99%

Current therapeutic developments in atrophic age-related macular degeneration

2015

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“…Opposed to anti-VEFG therapy of exudative AMD, there are not any currently approved treatment for GA. Current clinical trials are investigating remedies for dry GA through multiple approaches, including inflammation, the visual cycle, neuroprotection and cell replacement therapy [9][10][11][12]. Aetiology of dry AMD suggests that the treatment of inflammation could be a suitable alternative to treat dry AMD [13].…”

Section: Discussionmentioning

confidence: 99%

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2017

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“…Likewise, in dry AMD or non-exudative AMD, and then subsequently in geographic atrophy (GA), there are areas of progressive atrophy and thinning mainly involving the layers of the retinal pigment epithelium (RPE) and underlying choriocapillaris; these modifications are a prelude to the degeneration of photoreceptors leading to irreversible loss of visual function. [2][3][4] (Figure 1). The main risk factors for GA are ageing, family history, cigarette smoking, cardiovascular risk factors, previous cataract surgery, etc.…”

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confidence: 99%

“…Thus, the characteristics of GA with progressive and irreversible loss of retinal cells inevitably is responsible for around 20% of cases of legal blindness [1][2][3][4]. No effective treatment for GA is currently available, unlike neovascular AMD in which anti-angiogenic treatment are effective in improving visual acuity [4]. Inflammation, complement activation, oxidative stress, blood flow regulation, and reduced neuroprotection are the main pathways implicated in the progression of GA [3,4].…”

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confidence: 99%

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Therapeutic Approaches with Intravitreal Injections in Geographic Atrophy Secondary to Age-Related Macular Degeneration: Current Drugs and Potential Molecules

Nebbioso¹,

Lambìase²,

Cerini³

et al. 2019

Preprint

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The present review focuses on recent clinical trials that analyze the efficacy of intravitreal therapeutic agents for the treatment of dry age-related macular degeneration (AMD), such as neuroprotective drugs, and complement inhibitors, also called immunomodulatory or anti-inflammatory. A systematic literature search was performed to identify randomized controlled trials published prior to January 2019. Patients affected by dry AMD treated with intravitreal therapeutic agents were included. The changes in the correct visual acuity and the reduction in geographic atrophy progression were evaluated. Several new drugs have shown some promising results, including those targeting the complement cascade and agents called neuroprotective. The action potential of the two groups of drugs is to block the complement cascade model for immunomodulating agents, and prevent the degeneration and apoptosis of ganglion cells for the neuroprotectors, respectively. To the best of knowledge, and after extensive studies on the matter, there are still many investigations to be carried out on dry AMD in collaboration between researchers. They will have to identify truly effective molecules, understand the practical potential of pluripotent stem cells, and refine gene therapies. Only in-depth clinical trials will be able to allow the most appropriate and personalized treatments for each dry AMD patient.

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Geographic atrophy: clinical impact and emerging treatments

Cited by 24 publications

References 15 publications

Current therapeutic developments in atrophic age-related macular degeneration

Current therapeutic developments in atrophic age-related macular degeneration

Untitled

Therapeutic Approaches with Intravitreal Injections in Geographic Atrophy Secondary to Age-Related Macular Degeneration: Current Drugs and Potential Molecules

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