Abstract

Age-related macular degeneration (AMD) is a leading cause of blind registration in Western Europe and the third leading cause of blindness worldwide. The management of AMD is discussed with a review of current and new treatments. Although there is no treatment for advanced dry AMD (geographic atrophy), there have been considerable advances in the management of neovascular AMD (nAMD). Established therapies for nAMD include laser photocoagulation and photodynamic therapy (PDT), but these have largely been superseded by agents which block the action of vascular endothelial growth factor (anti-VEGF agents). Current preventative strategies involve cessation of smoking and use of specific nutritional supplements to reduce the risk of developing nAMD. There have been exciting advances in the treatment of nAMD and increased understanding of the genetics and pathogenic mechanisms involved will hopefully lead to the development of new therapies in the future.

Highlights

  • Accepted: January 10, 2008Correspondence to Mr A

  • Results: there is no treatment for advanced dry Age-related macular degeneration (AMD), there have been considerable advances in the management of neovascular AMD

  • Established therapies for neovascular AMD (nAMD) include laser photocoagulation and photodynamic therapy (PDT), but these have largely been superseded by agents which block the action of vascular endothelial growth factor

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Summary

Introduction

Accepted: January 10, 2008Correspondence to Mr A. CNV, choroidal neovascularization; MPS, Macular Photocoagulation Study; RCT, randomized controlled trial; SVL, severe visual loss (loss of six or more lines of visual acuity); MVL, moderate visual loss; RR, relative risk; PDT, photodynamic therapy; TAP, Treatment of Age-Related Macular degeneration with Photodynamic Therapy Study; VIP, Verteporfin in Photodynamic Therapy Study; VISION VEGF, Inhibition Study in Ocular Neovascularization; MARINA, Minimally classic/occult trial of the Anti-VEGF antibody Ranibizumab In the treatment of Neovascular AMD (presented but not published); ANCHOR, ANti-VEGF Antibody for the Treatment of Predominantly Classic CHORoidal Neovascularization in AMD (presented but not published); TCA, triamcinolone acetonide; BCVA, best corrected visual acuity; PCS, prospective case series; RCS, retrospective case series.

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