Abstract
Neovascular age-related macular degeneration is a leading cause of vision loss among the aging population. The current standard of care to treat neovascular age-related macular degeneration is inhibiting vascular endothelial growth factor (VEGF) through intravitreal injections. Recent studies have demonstrated that the tyrosine kinase with immunoglobulin-like and epidermal growth factor-like domains 2 (Tie2) pathway also plays a critical role in angiogenesis and vascular stability. Additionally, newly developed treatment delivery systems have been designed to greatly reduce the frequency of injections. In targeting the Tie2 pathway and utilizing a sustained release delivery system, patients may experience improved visual outcomes and a reduced burden of treatment.
Highlights
With a predicted worldwide prevalence of 288 million adults by 2040, age-related macular degeneration (AMD) is one of the leading causes of vision loss among individuals over 50 years old [1,2].Recent advances in anti-vascular endothelial growth factor agents have revolutionized the management of neovascular AMD, allowing patients to improve short-term visual acuity while slowing the progression of vision loss in the long-term
It has been hypothesized that this high rate of sub-responders is largely due to angiogenic factors and pathways other than vascular endothelial growth factor (VEGF) playing a role in the disease progression
Located on vascular endothelial cells, tyrosine kinase with immunoglobulin-like and epidermal growth factor-like domains 2 (Tie2) is a trans membrane receptor that serves as a binding site for the angiopoietin family of ligands that includes angiopoietin-1 (Ang1) and angiopoietin-2 (Ang2)
Summary
With a predicted worldwide prevalence of 288 million adults by 2040, age-related macular degeneration (AMD) is one of the leading causes of vision loss among individuals over 50 years old [1,2]. Long-term studies evaluating the efficacy of anti-VEGF agents have demonstrated that initial improvements in vision over the first two years are not always sustained over longer periods of time [6] This may be the result of under treatment in the real world setting or potentially the development of macular atrophy in these patients. Emerging treatment modalities for neovascular AMD aim to overcome the shortcomings of current agents by providing a more predictable improvement of vision while reducing the frequency of injections that are needed Among these modalities are emerging agents that target alternative angiogenic pathways, and delivery systems that allow a constant and sustained level of treatment
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