Department of Sense Organs, Faculty of Medicine and Odontology, Umberto I Policlinic, Sapienza University of Rome, p. le A. Moro 5, 00185 Rome, Italy.
Low Vision Research Centre of Milan, Piazza Sempione 3, 20145 Milan, Italy.
Int J Mol Sci. 2019 Apr 4;20(7):1693. doi: 10.3390/ijms20071693.
The present review focuses on recent clinical trials that analyze the efficacy of intravitreal therapeutic agents for the treatment of dry age-related macular degeneration (AMD), such as neuroprotective drugs, and complement inhibitors, also called immunomodulatory or anti-inflammatory agents. A systematic literature search was performed to identify randomized controlled trials published prior to January 2019. Patients affected by dry AMD treated with intravitreal therapeutic agents were included. Changes in the correct visual acuity and reduction in geographic atrophy progression were evaluated. Several new drugs have shown promising results, including those targeting the complement cascade and neuroprotective agents. The potential action of the two groups of drugs is to block complement cascade upregulation of immunomodulating agents, and to prevent the degeneration and apoptosis of ganglion cells for the neuroprotectors, respectively. Our analysis indicates that finding treatments for dry AMD will require continued collaboration among researchers to identify additional molecular targets and to fully interrogate the utility of pluripotent stem cells for personalized therapy.
本综述重点关注了最近的临床试验，这些试验分析了眼内治疗药物治疗干性年龄相关性黄斑变性（AMD）的疗效，如神经保护药物和补体抑制剂，也称为免疫调节或抗炎药物。进行了系统的文献检索，以确定在 2019 年 1 月之前发表的随机对照试验。纳入接受眼内治疗药物治疗的干性 AMD 患者。评估了正确视力的变化和地理萎缩进展的减少。包括针对补体级联和神经保护剂的几种新药已显示出有希望的结果。这两组药物的潜在作用分别是阻止补体级联上调免疫调节剂，并分别防止神经保护剂的神经节细胞变性和细胞凋亡。我们的分析表明，寻找干性 AMD 的治疗方法需要研究人员继续合作，以确定其他分子靶点，并充分研究多能干细胞在个性化治疗中的应用。
