Abstract
Age-related macular degeneration (AMD) is a leading cause of legal blindness in developed countries. Even with the recent advent of several treatment options such as photodynamic therapy (PDT) and anti-vascular endothelial growth factor (VEGF) therapy for the treatment of exudative AMD, characterized by choroidal neovascularization (CNV), their efficacy is still limited. Thus, in this review article, we investigated novel drug delivery system for AMD using nanotechnology. Polyion complex (PIC) micelle has a size range of several tens of nanometers formed through electrostatic interaction, and accumulates in solid tumors through enhanced permeability and retention (EPR) effect. The distribution of the PIC micelle encapsulating fluorescein isothiocyanate-labeled poly-l-lysine (FITC-P(Lys)) in experimental CNV in rats was investigated. PIC micelle accumulates in the CNV lesions and is retained in the lesion for as long as 168 h after intravenous administration. PIC micelles can be used for achieving effective drug delivery system to CNV. Although PDT is a main treatment option for CNV, most patients require repeated treatments. For effective PDT against AMD, the selective delivery of photosensitizer to the CNV lesions and an effective photochemical reaction at the CNV site are necessary. The characteristic dendritic structure of the photosensitizer prevents aggregation of its core sensitizer, thereby inducing a highly effective photochemical reaction. A supramolecular nanomedical device, i.e., a novel dendritic photosensitizer encapsulated by a polymeric micelle formulation was employed for an effective PDT for AMD. With its highly selective accumulation on CNV lesions, this treatment resulted in a remarkably efficacious CNV occlusion with minimal unfavorable phototoxicity. Our results will provide a basis for an effective approach to PDT for AMD.
Published Version
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