Current and emerging therapies for the treatment of age-related macular degeneration

M Vaughn Emerson, Andreas K LauerCasey Eye Institute, Oregon Health and Science University, Portland, OR, USAAbstract: Age-related macular degeneration (AMD) is the leading cause of vision loss in the industrialized world. In the last few decades, the mainstay of treatment for choroidal neovasculari...

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Autores principales:	M Vaughn Emerson, Andreas K Lauer
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/f5155625e76646afaa05f4af2e509fa7
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spelling	oai:doaj.org-article:f5155625e76646afaa05f4af2e509fa72021-12-02T08:33:37ZCurrent and emerging therapies for the treatment of age-related macular degeneration1177-54671177-5483https://doaj.org/article/f5155625e76646afaa05f4af2e509fa72008-06-01T00:00:00Zhttp://www.dovepress.com/current-and-emerging-therapies-for-the-treatment-of-age-related-macula-a1793https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483M Vaughn Emerson, Andreas K LauerCasey Eye Institute, Oregon Health and Science University, Portland, OR, USAAbstract: Age-related macular degeneration (AMD) is the leading cause of vision loss in the industrialized world. In the last few decades, the mainstay of treatment for choroidal neovascularization (CNV) due to AMD has been thermal laser photocoagulation. In the last decade, photodynamic therapy with verteporfin extended treatment for more patients. While both of these treatments have prevented further vision loss in a subset of patients, improvement in visual acuity is rare. Anti-vascular endothelial growth factor A (VEGF) therapy has revolutionized the treatment of AMD-related CNV. Pegaptanib, an anti-VEGF aptamer prevents vision loss in CNV, although the performance is similar to that of photodynamic therapy. Ranibizumab, an antibody fragment and bevacizumab, a full-length humanized monoclonal antibody against VEGF have both shown promising results with improvements in visual acuity with either agent. VEGF trap, a modified soluble VEGF receptor analogue, binds VEGF more tightly than all other anti-VEGF agents and has also shown promising results in early trials. Other treatment strategies to decrease the effect of VEGF have used small interfering ribonucleic acid (RNA) to inhibit VEGF production and VEGF receptor production. Steroids, including anecortave acetate in the treatment and prevention of CNV, have shown promise in controlled trials. Receptor tyrosine kinase inhibitors, such as vatalanib, inhibit downstream effects of VEGF, and have been effective in the treatment of CNV in early studies. Squalamine lactate inhibits plasma membrane ion channels with downstream effects on VEGF, and has shown promising results with systemic administration. Other growth factors, including pigment epithelium-derived growth factor that has been administered via an adenoviral vector has shown promising initial results. In some patients ciliary neurotrophic factor is currently being studied for the inhibition of progression of geographic atrophy. Combination therapy has been investigated, and may prove to be more effective in the management of AMD-associated CNV. Ongoing and future studies will be crucial for optimizing the treatment of patients with AMD.Keywords: age related macular degeneration, macular degeneration, VEGF, VEGF antagonist, anti-VEGF, choroidal neovascularization M Vaughn EmersonAndreas K LauerDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2008, Iss Issue 2, Pp 377-388 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 M Vaughn Emerson Andreas K Lauer Current and emerging therapies for the treatment of age-related macular degeneration
description	M Vaughn Emerson, Andreas K LauerCasey Eye Institute, Oregon Health and Science University, Portland, OR, USAAbstract: Age-related macular degeneration (AMD) is the leading cause of vision loss in the industrialized world. In the last few decades, the mainstay of treatment for choroidal neovascularization (CNV) due to AMD has been thermal laser photocoagulation. In the last decade, photodynamic therapy with verteporfin extended treatment for more patients. While both of these treatments have prevented further vision loss in a subset of patients, improvement in visual acuity is rare. Anti-vascular endothelial growth factor A (VEGF) therapy has revolutionized the treatment of AMD-related CNV. Pegaptanib, an anti-VEGF aptamer prevents vision loss in CNV, although the performance is similar to that of photodynamic therapy. Ranibizumab, an antibody fragment and bevacizumab, a full-length humanized monoclonal antibody against VEGF have both shown promising results with improvements in visual acuity with either agent. VEGF trap, a modified soluble VEGF receptor analogue, binds VEGF more tightly than all other anti-VEGF agents and has also shown promising results in early trials. Other treatment strategies to decrease the effect of VEGF have used small interfering ribonucleic acid (RNA) to inhibit VEGF production and VEGF receptor production. Steroids, including anecortave acetate in the treatment and prevention of CNV, have shown promise in controlled trials. Receptor tyrosine kinase inhibitors, such as vatalanib, inhibit downstream effects of VEGF, and have been effective in the treatment of CNV in early studies. Squalamine lactate inhibits plasma membrane ion channels with downstream effects on VEGF, and has shown promising results with systemic administration. Other growth factors, including pigment epithelium-derived growth factor that has been administered via an adenoviral vector has shown promising initial results. In some patients ciliary neurotrophic factor is currently being studied for the inhibition of progression of geographic atrophy. Combination therapy has been investigated, and may prove to be more effective in the management of AMD-associated CNV. Ongoing and future studies will be crucial for optimizing the treatment of patients with AMD.Keywords: age related macular degeneration, macular degeneration, VEGF, VEGF antagonist, anti-VEGF, choroidal neovascularization
format	article
author	M Vaughn Emerson Andreas K Lauer
author_facet	M Vaughn Emerson Andreas K Lauer
author_sort	M Vaughn Emerson
title	Current and emerging therapies for the treatment of age-related macular degeneration
title_short	Current and emerging therapies for the treatment of age-related macular degeneration
title_full	Current and emerging therapies for the treatment of age-related macular degeneration
title_fullStr	Current and emerging therapies for the treatment of age-related macular degeneration
title_full_unstemmed	Current and emerging therapies for the treatment of age-related macular degeneration
title_sort	current and emerging therapies for the treatment of age-related macular degeneration
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/f5155625e76646afaa05f4af2e509fa7
work_keys_str_mv	AT mvaughnemerson currentandemergingtherapiesforthetreatmentofagerelatedmaculardegeneration AT andreasklauer currentandemergingtherapiesforthetreatmentofagerelatedmaculardegeneration
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Current and emerging therapies for the treatment of age-related macular degeneration

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