scholarly journals Steroid Therapy in Wet-Form (Neovascular) Age-Related Macular Degeneration

2017 ◽  
pp. 213-218
Keyword(s):  
Macular Degeneration ◽  
Gold Standard ◽  
Age Related Macular Degeneration ◽  
Vascular Endothelial ◽  
Age Related ◽  
Factor Expression ◽  
Growth Factor Expression ◽  
Treatment Procedures ◽  
Endothelial Growth Factor ◽  
Wet Amd

Wet-form (neovascular) age-related macular degeneration (AMD) is characterized by the development of choroidal neovascularization. Pathogenesis of disease involves inflammation, angiogenesis, and fibrosis through complex mechanisms that have interactions among different cytokines. Although anti- VEGF agents are the gold standard in treatment, the main goal of the effective treatment for wet AMD is to inhibit all mechanisms involved in pathogenesis, including inflammatory cascades. In addition to the anti-inflammatory effects steroids reduce the permeability of choroidal cells and are anti-angiogenic via suppressing vascular endothelial growth factor expression. Triamcinolone and dexamethasone are the steroids used in monotherapy and combination therapy in wet AMD; nevertheless studies had shown that these steroids may stabilize or gain vision and provide fewer treatment procedures.

scholarly journals Recent advances in the management and understanding of macular degeneration

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 519 ◽  
Author(s):  
Sepehr Bahadorani ◽  
Michael Singer
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Vascular Endothelial ◽  
Current Management ◽  
Vegf Inhibitors ◽  
Age Related ◽  
Dry Amd ◽  
Endothelial Growth Factor ◽  
Wet Amd

Current management of age-related macular degeneration (AMD) is directed at intravitreal injection of vascular endothelial growth factor (VEGF) inhibitors for the treatment of wet AMD and supplementation with oral antioxidants for the treatment of dry AMD. In this article, we will review recent clinical trials for the treatment of dry and wet AMD.

scholarly journals Saccadic movement effects on intraocular drug delivery for a wet-AMD clinical case

2018 ◽  
Vol 2 (2) ◽  
pp. 86-91
Author(s):  
Marco Ferroni ◽  
Matteo Cereda ◽  
Federica Boschetti
Keyword(s):  
Drug Delivery ◽  
Gold Standard ◽  
Transport Mechanism ◽  
Age Related Macular Degeneration ◽  
Vascular Endothelial ◽  
Saccadic Movement ◽  
Age Related ◽  
Intraocular Drug Delivery ◽  
Endothelial Growth Factor ◽  
Wet Amd

Nowadays, intravitreal injections are the gold standard for the treatment of age-related macular degeneration (AMD). The prediction of the transport mechanism for the injected anti vascular endothelial growth factor (anti-VEGF) is needed in order to understand its distribution and consumption after each injection. Thus, this study aims at implementing a full model of vitreous drug delivery. The main novelty of this work is the coupling between an experimental evaluation of the scleral permeability and a numerical analysis of the saccadic dependency of the transport phenomena.

scholarly journals Proportion of and Reason for Bevacizumab Usage in the Treatment of Wet Age-related Macular Degeneration

2021 ◽  
Vol 62 (8) ◽  
pp. 1076-1083
Author(s):  
Yi Sang Yoon ◽  
Won Tae Yoon ◽  
Jong Woo Kim ◽  
Chul Gu Kim ◽  
Jae Hui Kim
Keyword(s):  
Macular Degeneration ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Common Reason ◽  
Vascular Endothelial ◽  
Corrected Visual Acuity ◽  
Anti Vegf ◽  
Age Related ◽  
Endothelial Growth Factor ◽  
Wet Amd

Purpose: To evaluate the proportion of bevacizumab and the reason for its usage in wet age-related macular degeneration (AMD).Methods: Retrospective analysis of medical records was performed for 1,541 patients who received ranibizumab, aflibercept, or bevacizumab injection to treat wet AMD. The proportion of bevacizumab among the entire set of injections was identified. The reason for selecting bevacizumab was additionally identified.Results: During the study period, a total of 2,929 anti-vascular endothelial growth factor (anti-VEGF) injections were performed; 2,236 (76.3%) were ranibizumab or aflibercept injections and 693 (23.7%) were bevacizumab injections. The most common reason for bevacizumab usage was ‘having a 0.1 or worse best-corrected visual acuity or being unable to assure reimbursement due to the development of extensive scarring or geographic atrophy’ (297 bevacizumab injections, 42.9%). The second most common reason was ‘the inability to assure reimbursement such as extrafoveal choroidal neovascularization (CNV) or early CNV without definite fluid in the foveal region’ (201 bevacizumab injections, 29.0%).Conclusions: Bevacizumab was used in 23.7% of the anti-VEGF injections to treat wet AMD. When analyzing patients’ treatment burden and financial impact, the results of the present study may provide useful information. Further multi-center studies are required to evaluate more precisely the usage of anti-VEGF drugs.

scholarly journals PPAR-αLigands as Potential Therapeutic Agents for Wet Age-Related Macular Degeneration

PPAR Research ◽  
2008 ◽  
Vol 2008 ◽  
pp. 1-5 ◽  
Author(s):  
Marisol del V Cano ◽  
Peter L. Gehlbach
Keyword(s):  
Macular Degeneration ◽  
Immune Modulation ◽  
Age Related Macular Degeneration ◽  
Peroxisome Proliferator ◽  
Vascular Endothelial ◽  
Age Related ◽  
Dry Amd ◽  
Peroxisome Proliferator Activated Receptors ◽  
Endothelial Growth Factor ◽  
Wet Amd

The peroxisome proliferator-activated receptors (PPAR's) are members of the steroid/thyroid nuclear receptor, superfamily of transcription factors. There are currently three known PPAR subtypes,α,β, andγ. The PPARs are now recognized participants in a number of biological pathways some of which are implicated in the pathogenesis of age-related macular degeneration (AMD). These include immune modulation, lipid regulation, and oxidant/antioxidant pathways important to the onset and progression of “dry” AMD, and vascular endothelial growth factor (VEGF) mediated pathways that stimulate choroidal neovascularization (CNV), characteristic of “wet” AMD. PPAR-αis found in retina and also on vascular cells important to formation of CNV. At this time, however, relatively little is known about potential contributions of PPAR-αto the pathogenesis of dry and wet AMD. This review examines current literature for potential roles of PPAR-αin the pathogenesis and potential treatment of AMD with emphasis on prevention and treatment of wet AMD.

Combination Therapy for Wet Age-related Macular Degeneration

2009 ◽  
Vol 03 (02) ◽  
pp. 98
Author(s):  
Albert J Augustin ◽  
Stephan Scholl ◽  
◽  
Keyword(s):  
Combination Therapy ◽  
Macular Degeneration ◽  
Clinical Evidence ◽  
Age Related Macular Degeneration ◽  
Vascular Endothelial ◽  
Triple Combination Therapy ◽  
Age Related ◽  
Expression Evidence ◽  
Endothelial Growth Factor ◽  
Wet Amd

Increasing appreciation of the complexity of the wet type of age-related macular degeneration (AMD) has made combination therapy an area of current intense interest. Administered in dual or triple combinations, the current therapeutic mainstays ߝ corticosteroids, verteporfin photodynamic therapy (V-PDT) and inhibitors of vascular endothelial growth factor (VEGF) ߝ have more potential to successfully treat the various pathogenetic factors contributing to wet AMD than any single-therapy approach. The different mechanisms of action involved in combination therapy are intended to reduce inflammation, eradicate current and future choroidal neovascularisation and lessen VEGF expression. Evidence from clinical trials demonstrates visual acuity benefits, lower re-treatment rates and longer treatment-free intervals with combination therapies compared with monotherapies. This article summarises the rationale and the clinical evidence that support the use of double and triple combination therapy in wet AMD.

scholarly journals The role of future treatments in the management of neovascular age-related macular degeneration in Europe

2021 ◽  
pp. 112067212110183
Author(s):  
Laurent Kodjikian ◽  
Carl Joe Mehanna ◽  
Salomon-Yves Cohen ◽  
François Devin ◽  
Sam Razavi ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Phase Iii ◽  
Vascular Endothelial ◽  
Real World Data ◽  
Phase Iii Clinical Trials ◽  
Age Related ◽  
Injection Frequency ◽  
Endothelial Growth Factor

Anti-vascular endothelial growth factor (VEGF) agents have transformed the management of patients with neovascular age-related macular degeneration (nAMD) over the past two decades. However, as more long-term real-world data become available, it is clear that treatment outcomes are inferior to those reported in large, controlled clinical trials. This is largely driven by undertreatment, that is, not maintaining a consistent injection frequency to achieve sustained VEGF suppression, whether due to patient non-compliance, an important injection burden, or non/incomplete anatomical response. Newer therapeutic advances under evaluation hold promise in achieving more, for less. We review the latest drugs currently in or having successfully finished phase III clinical trials, and determine their potential place in the management of patients with nAMD in Europe.

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