Abstract
Age-related macular degeneration (AMD) constitutes a prevalent, chronic, and progressive retinal degenerative disease of the macula that affects elderly people and cause central vision impairment. Despite therapeutic advances in the management of neovascular AMD, none of the currently used treatments cures the disease or reverses its course. Medical treatment of neovascular AMD experienced a significant advance due to the introduction of vascular endothelial growth factor inhibitors (anti-VEGF), which dramatically changed the prognosis of the disease. However, although anti-VEGF therapy has become the standard treatment for neovascular AMD, many patients do not respond adequately to this therapy or experience a slow loss of efficacy of anti-VEGF agents after repeated administration. Additionally, current treatment with intravitreal anti-VEGF agents is associated with a significant treatment burden for patients, caregivers, and physicians. New approaches have been proposed for treating neovascular AMD. Among them, designed ankyrin repeat proteins (DARPins) seem to be as effective as monthly ranibizumab, but with greater durability, which may enhance patient compliance with needed injections.
Highlights
Age-related macular degeneration (AMD) constitutes a prevalent, chronic, and progressive retinal degenerative disease of the macula that affects elderly people and causes central vision impairment as a result of damage to retina, retinal pigment epithelium (RPE), and choriocapillaris [1,2,3].AMD constitutes one of the leading causes of irreversible visual impairment in developed countries [4,5,6,7,8,9,10,11,12,13]
This study aims to provide an overview of our current understanding of the neovascular AMD (NVAMD), focusing on its current management and its future trends
In NVAMD, choroidal neovascularization (CNV) may be considered as a secondary reaction promoted by either stressor damage to the RPE or an immune response, which may result in hypoxia and up-regulation of angiogenic factors in the choroid, leading to the formation of pathological vessels [72,73,74]
Summary
Age-related macular degeneration (AMD) constitutes a prevalent, chronic, and progressive retinal degenerative disease of the macula that affects elderly people and causes central vision impairment as a result of damage to retina, retinal pigment epithelium (RPE), and choriocapillaris [1,2,3]. The results of a metanalysis that included 129,664 subjects, with 12,727 cases from 39 studies, showed that the prevalence of AMD ranged from 7.3% in Asian populations to 12.3% in European ancestry populations [4]. Such prevalence rate variations among the different populations may be explained by genetic differences, lifestyle, and/or dietary factors [14,15]. This study aims to provide an overview of our current understanding of the neovascular AMD (NVAMD), focusing on its current management and its future trends
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