Neovascular Age-Related Macular Degeneration: Rationale for Current Treatment Guidelines

2013 ◽  
pp. 107-125
Author(s):  
Connie J. Chen ◽  
Neil M. Bressler
Keyword(s):  
Macular Degeneration ◽  
Treatment Guidelines ◽  
Current Treatment ◽  
Age Related Macular Degeneration ◽  
Age Related

scholarly journals Age-related Macular Degeneration—Disease, Risk Factors, and Treatments

2014 ◽  
Vol 07 (02) ◽  
pp. 154
Author(s):  
Clyde Schultz ◽  
Keyword(s):  
Risk Factors ◽  
Macular Degeneration ◽  
Genetic Factors ◽  
Progressive Disease ◽  
Disease Risk ◽  
Treatment Options ◽  
Current Treatment ◽  
Posterior Segment ◽  
Age Related Macular Degeneration ◽  
Age Related

Age-related macular degeneration (AMD) is a progressive disease of the posterior segment of the eye. It is has been diagnosed worldwide and primarily affects individuals over 50 years of age. The incidence of the disease increases with age and with the presence of certain genetic factors, which may indicate a disposition for disease progression. In addition to genetic factors and age, other factors may be involved in developing AMD. These include obesity and smoking, which are also linked to various cardiovascular conditions. There are two forms of AMD: wet and dry. Both forms may involve the build-up of drusen deposits in the posterior segment of the eye, but the wet form tends to be more severe due to the proliferation of blood vessels into the macula and retinal areas of the back of the eye, thus causing an individual’s vision to become ‘blocked’ or ‘shaded’ usually beginning at the center of the visual field. There are a variety of treatment options for AMD including surgery in the form of laser or photo therapy. The most current treatment options involve the injection of a biologic into the posterior segment of the eye. There are some severe adverse events with this approach but they tend to be rare.

Macular Degeneration: An Overview

1991 ◽  
Vol 85 (6) ◽  
pp. 249-252 ◽  
Author(s):  
L.M. Chalifoux
Keyword(s):  
Macular Degeneration ◽  
Visual Loss ◽  
Psychosocial Problems ◽  
Current Treatment ◽  
Age Related Macular Degeneration ◽  
Age Related

This article presents an overview of information on macular degeneration for professionals who help persons with the disease adjust to their visual loss. It covers the types of macular degeneration, the etiology of the disease, and current treatment. In addition, it presents a composite case study, drawn from recent research, on the psychosocial problems and other difficulties that persons with age-related macular degeneration face.

scholarly journals Neovascular Age-Related Macular Degeneration: Therapeutic Management and New-Upcoming Approaches

2020 ◽  
Vol 21 (21) ◽  
pp. 8242
Author(s):  
Federico Ricci ◽  
Francesco Bandello ◽  
Pierluigi Navarra ◽  
Giovanni Staurenghi ◽  
Michael Stumpp ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Repeated Administration ◽  
Current Treatment ◽  
Age Related Macular Degeneration ◽  
Significant Advance ◽  
Neovascular Amd ◽  
Significant Treatment ◽  
Anti Vegf ◽  
Age Related ◽  
Ankyrin Repeat Proteins

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.

scholarly journals Sunitinib-Loaded MPEG-PCL Micelles for the Treatment of Age-Related Macular Degeneration

2020 ◽  
Vol 88 (3) ◽  
pp. 30 ◽  
Author(s):  
Jarriaun Streets ◽  
Priyanka Bhatt ◽  
Deepak Bhatia ◽  
Vijaykumar Sutariya
Keyword(s):  
Macular Degeneration ◽  
Polymeric Micelles ◽  
Retinal Pigment Epithelial Cell ◽  
Retinal Pigment ◽  
Current Treatment ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Epithelial Cell Line ◽  
Anti Vegf ◽  
Age Related

Age-related macular degeneration (AMD) will be responsible for the vision impairment of more than five million late-aged adults in the next 30 years. Current treatment includes frequent intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents. However, there are methods of drug delivery that can decrease the frequency of intravitreal injections by sustaining drug release. MPEG-PCL ((methoxypoly(ethylene glycol) poly(caprolactone)) has been reported as biocompatible and biodegradable. Polymeric micelles of MPEG-PCL can be useful in efficiently delivering anti-VEGF drugs such as sunitinib to the posterior segment of the eye. In this study, the novel micellar formulation exhibited an average dynamic light scattering (DLS) particle size of 134.2 ± 2.3 nm with a zeta potential of −0.159 ± 0.07 mV. TEM imaging further confirmed the nanoscopic size of the micelles. A sunitinib malate (SM)-MPEG-PCL formulation exhibited a sustained release profile for up to seven days with an overall release percentage of 95.56 ± 2.7%. In addition to their miniscule size, the SM-MPEG-PCL formulation showed minimal cytotoxicity onto the ARPE-19 human retinal pigment epithelial cell line, reporting a percent viability of more than 88% for all concentrations tested at time intervals of 24 h. The SM-MPEG-PCL micelles also exhibited exceptional performance during an anti-VEGF ELISA that decreased the overall VEGF protein expression in the cells across a 24–72 h period. Furthermore, it can be concluded that this type of polymeric vehicle is a promising solution to symptoms caused by AMD and improving the management of those suffering from AMD.

scholarly journals Fixed Regimen Treatment in Unselected Naïve Patients Cohort with Neovascular Age-Related Macular Degeneration

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Ricardo P. Casaroli-Marano ◽  
Carolina Bernal-Morales ◽  
Lillian Chamorro-López ◽  
Marina Dotti-Boada ◽  
Juan P. Figueroa-Vercellino ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
The Elderly ◽  
Current Treatment ◽  
Age Related Macular Degeneration ◽  
The Public ◽  
Age Related ◽  
Intravitreal Aflibercept ◽  
One Year

The current treatment of neovascular age-related macular degeneration (nAMD) generates an excessive care pressure in the public health system. The search for a satisfactory treatment regimen, whose anatomical and functional stability may be achieved, is a challenge and a goal to be reached. We analyzed the outcomes in a patient cohort under fixed regimen treatment with intravitreal aflibercept (IVA). A retrospective study, with at least 1-year follow-up, in consecutive treated unselected naïve patients was carried out. Standard protocol was performed and evaluated at baseline, month 4 (after loading dose, LD), and month 12 (after fixed bimonthly regimen). One hundred six patients (123 eyes) aged 80.3 ± 7.7 years were included, receiving 6.8 ± 0.7 IVA. Visual acuity gain after LD was 5.5 ± 12.0 letters ( p < 0.0001 ). At month 12, 23 eyes (18.7%) gained ≥15 letters and 58 (47.1%) had best-corrected visual acuity ≥20/40 (70 letters). The improvement in visual acuity was lower in patients with polypoidal choroidal vasculopathy (+4.9 ± 18.1 letters; p = 0.2544) and somewhat higher in patients with retinal angiomatous proliferation (+5.4 ± 12.3 letters; p = 0.0373 ). Dry macula was present in only 9.8% of cohort at baseline vs. 69.7% at month 12 ( p < 0.0001 ). Atrophy was the most observed complication and related to the elderly patients. The average of follow-up visits was 3 ± 0.5. Functional and anatomical improvement were observed with IVA in a fixed bimonthly regimen treatment after LD, with results maintained up to one year with a good compliance. The fixed bimonthly regimen optimized patient management and logistic issues.

Current Treatment of Age-Related Macular Degeneration

2007 ◽  
Vol 84 (7) ◽  
pp. E559-E572 ◽  
Author(s):  
MARCO ZARBIN ◽  
BERNARD SZIRTH
Keyword(s):  
Macular Degeneration ◽  
Current Treatment ◽  
Age Related Macular Degeneration ◽  
Age Related
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