Department of Experimental Medicine, University Tor Vergata, Viale Oxford, 00133 Rome, Italy.
Scientific Institute San Raffaele, University Vita Salute, 20132 Milan, Italy.
Int J Mol Sci. 2020 Nov 3;21(21):8242. doi: 10.3390/ijms21218242.
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.
年龄相关性黄斑变性（AMD）是一种常见的、慢性的、进行性的黄斑部视网膜退行性疾病，影响老年人，导致中心视力损害。尽管在新生血管性 AMD 的治疗方面取得了进展，但目前使用的任何治疗方法都不能治愈该疾病或逆转其病程。新生血管性 AMD 的药物治疗因血管内皮生长因子抑制剂（抗 VEGF）的引入而取得了重大进展，这极大地改变了该疾病的预后。然而，尽管抗 VEGF 治疗已成为新生血管性 AMD 的标准治疗方法，但许多患者对此治疗反应不足，或在反复给药后抗 VEGF 药物的疗效逐渐丧失。此外，目前玻璃体内抗 VEGF 药物的治疗会给患者、护理人员和医生带来沉重的负担。目前已经提出了治疗新生血管性 AMD 的新方法。其中，设计的锚蛋白重复蛋白（DARPins）似乎与每月雷珠单抗同样有效，但持久性更强，这可能会提高患者对所需注射的依从性。
