Abstract
Age-related macular degeneration (AMD) is a progressive neurodegenerative disease that is the world’s leading cause of blindness in the aging population. Although the clinical stages and forms of AMD have been elucidated, more specific prognostic tools are required to determine when patients with early and intermediate AMD will progress into the advanced stages of AMD. Another challenge in the field has been the appropriate development of therapies for intermediate AMD and advanced atrophic AMD. After numerous negative clinical trials, an anti-C5 agent and anti-C3 agent have recently shown promising results in phase 3 clinical trials, in terms of slowing the growth of geographic atrophy, an advanced form of AMD. Interestingly, both drugs appear to be associated with an increased incidence of wet AMD, another advanced form of the disease, and will require frequent intravitreal injections. Certainly, there remains a need for other therapeutic agents with the potential to prevent progression to advanced stages of the disease. Investigation of the role and clinical utility of non-coding RNAs (ncRNAs) is a major advancement in biology that has only been minimally applied to AMD. In the following review, we discuss the clinical relevance of ncRNAs in AMD as both biomarkers and therapeutic targets.
Highlights
Age-related macular degeneration (AMD) is a progressive neurodegenerative disease that is the world’s leading cause of blindness in the aging population [1]
Investigation of the role and clinical utility of non-coding RNAs is a major advancement in biology that has only been minimally applied to AMD [31–36]
These non-coding RNAs (ncRNAs) differ from coding RNA or messenger ribonucleic acid in that they do not encode for proteins, but rather influence gene expression through a variety of means
Summary
Age-related macular degeneration (AMD) is a progressive neurodegenerative disease that is the world’s leading cause of blindness in the aging population [1]. As the burden of these deposits increases, the disease can be categorized into early, intermediate, or advanced stages, taking into account hyper- or hypopigmentary changes of the RPE and the presence or absence of macular neovascularization (MNV) and areas of atrophy of the RPE and outer retina [6]. The clinical presentation of these two differ dramatically, in that the wet form can cause rapid severe vision loss secondary to the development of new abnormal blood vessels in the normally avascular sub-RPE and sub-retinal regions, previously termed choroidal neovascularization, more recently named macular neovascularization [13]. The clinical course towards advanced dry AMD is typically gradual and accompanied by an increasing burden of drusen, RPE pigmentary abnormalities, and subretinal deposits known as reticular pseudodrusen. AMD patients continue to represent a large population of individuals referred for low vision rehabilitation due to irreversible vision loss
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