Abstract
Age-related macular degeneration (AMD) is the leading cause of vision loss in geriatric population. Intravitreal (IVT) injections are popular clinical option. Biologics and small molecules offer efficacy but relatively shorter half-life after intravitreal injections. To address these challenges, numerous technologies and therapies are under development. Most of these strategies aim to reduce the frequency of injections, thereby increasing patient compliance and reducing patient-associated burden. Unlike IVT frequent injections, molecular therapies such as cell therapy and gene therapy offer restoration ability hence gained a lot of traction. The recent approval of ocular gene therapy for inherited disease offers new hope in this direction. However, until such breakthrough therapies are available to the majority of patients, antibody therapeutics will be on the shelf, continuing to provide therapeutic benefits. The present review aims to highlight the status of pre-clinical and clinical studies of neovascular AMD treatment modalities including Anti-VEGF therapy, upcoming bispecific antibodies, small molecules, port delivery systems, photodynamic therapy, radiation therapy, gene therapy, cell therapy, and combination therapies.
Highlights
Age-related macular degeneration (AMD) is the leading cause of vision loss in developed countries with prevalence rates ranging from 5–40% based on ethnicity [1,2]
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When Luis et al manufactured Bevacizumab loaded human serum albumin (HSA) NPs for topical administration, the findings suggested that the formulated NPs exhibited improved efficacy in neovascularized mouse models compared to poly glycol (PEG) coated HSA NPs
Summary
Age-related macular degeneration (AMD) is the leading cause of vision loss in developed countries with prevalence rates ranging from 5–40% based on ethnicity [1,2]. The intravitreal injection (IVT) route is currently in use for anti-VEGF (Vascular Endothelial Growth Factor) agents. It is an invasive route and causes difficulty to patients, but alternative clinical outcomes are bleak at present [4,5]. Various administrative routes are explored, such as periocular, suprachoroidal, sub-retinal, systemic, and topical routes for the delivery of small molecules, biologics, and gene therapy [6]. We highlight preclinical and clinical studies of wet AMD treatment modalities such as anti-VEGF therapy, including antibodies, bispecific antibodies, small molecules, photodynamic therapy, radiation therapy, gene therapy, and cell therapy. We are providing information on sustained-release strategies and pharmacokinetics aspects to reduce the need for frequent injections [23]
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