Neovascular Age-Related Macular Degeneration

Abstract

Purpose: Neovascular age-related macular degeneration (AMD) is a leading cause of blindness, with an increasing incidence as the elderly population expands. Large, multi-center, randomized, clinical trials have been conducted exploring the safety and efficacy of anti-VEGF treatments. This paper aims to discuss the safety and efficacy of pegaptanib, ranibizumab, aflibercept and bevacizumab. New therapeutic agents and treatment strategies are also discussed. Procedures: Evidence available from prospective, multicenter, clinical studies and from a selective literature search is utilized to present the results of VEGF inhibition in neovascular AMD and to generate evidence-based recommendations. Results: Anti-VEGF treatment is indicated in choroidal neovascularization with active disease and produces a significant benefit in visual acuity. Conclusions: With the advent of anti-VEGF therapy, the prognosis of choroidal neovascularization has changed dramatically. Data from well-conducted clinical trials suggest that approved anti-VEGF drugs are effective and well tolerated.

Next-generation sequencing analysis of the ARMS2 gene in Turkish exudative age-related macular degeneration patients

“…Mitochondrial dysfunction resulting from aging may lead to compromised energy metabolism, accumulation of mitochondrial DNA mutations, and subsequent activation of apoptotic pathways (Lin and Beal, 2006;McBride et al, 2006). Compared to healthy individuals, in the retinas AMD patients, mitochondrial number and size are decreased, cristae are lost, and mitochondrial DNA mutations accumulate (Veritti et al, 2012;Kaszubski et al, 2016).…”

“…The former is characterized by a thickening of Bruch's membrane, accumulation of drusen beneath the retinal pigment epithelium (RPE), and geographic atrophy, with loss of the RPE and photoreceptors in the macula. Exudative AMD, by contrast, is characterized by choroidal neovascularization (CNV), defined by the growth of new, fragile choroidal blood vessels, which penetrate Bruch's membrane, resulting in invasion of the retina with leaking vasculature (Ambati and Fowler, 2012;Veritti et al, 2012;van Lookeren Campagne et al, 2014;Kaszubski et al, 2016). The prevalence of AMD is 2.1% among individuals aged 40-49 years, increasing to 35% for those >80 years old.…”

Use of Human Embryonic Stem Cells in the Treatment of Age-Related Macular Degeneration

“…Excessive amount of vascular endothelial growth factor (VEGF) has been demonstrated as an underlying cause of increased neovasularization (immature and abnormal growth of blood vessels) in choroid layer and these abnormal vessels are susceptible to hemorrhage, causing macular damage [16]. Anti-VEGF therapies including bevacizumab and ranibizumab are available to obstruct abnormal neovascularization [17], but are known to result in side effects such as macular hemorrhages [18]. Surgical treatment involves translocation of macula towards the undamaged RPE.…”

Toll-like receptor 3 polymorphism is not associated with neovascular age-related macular degeneration and polypoidal choroidal vasculopathy in the Chinese

“…This is consistent with Sng et al (2011) and Zhou et al (2011), who proposed that the TLR3 mutation reduces binding capacity to dsRNA, protecting against GA rather than the neovascular phenotype. Moreover, genes that have been implicated in the pathogenesis of nAMD and PCV are usually factors likely involved in ischemia, inflammation, and local synthesis and secretion of angiogenic factors (Swaroop et al, 2007;Veritti et al, 2012).…”