Patel Prem, Sheth Veeral
Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
University Retina and Macula Associates, Oak Forest, IL 60452, USA.
J Clin Med. 2021 May 30;10(11):2436. doi: 10.3390/jcm10112436.
Age-related macular degeneration (AMD) is one of the most common causes of vision loss. Advanced forms of AMD are seen in primarily two types-neovascular AMD (nAMD) with the presence of choroid neovascularization and non-neovascular AMD (nnAMD) with geographic atrophy. Neovascular AMD is characterized by choroidal neovascularization (CNV), which leads to a cascade of complications, including exudation, leakage, and ultimately fibrosis with photoreceptor loss. Inhibition of VEGF represents the current standard of care. However, there is a tremendous gap between the outcomes in randomized clinical trials and real-world settings. New agents for nAMD might offer the potential to improve treatment outcomes and reduce treatment of frequent intravitreal injections. We summarize all the newer molecules, their pivotal clinical trial results, and their unique mechanisms of action; these include longer-acting agents, combination strategies, sustained release, and genetic therapies.
年龄相关性黄斑变性（AMD）是导致视力丧失的最常见原因之一。AMD的晚期形式主要有两种类型：存在脉络膜新生血管的新生血管性AMD（nAMD）和伴有地图状萎缩的非新生血管性AMD（nnAMD）。新生血管性AMD的特征是脉络膜新生血管（CNV），这会导致一系列并发症，包括渗出、渗漏，并最终发展为伴有光感受器丧失的纤维化。抑制血管内皮生长因子（VEGF）是目前的标准治疗方法。然而，随机临床试验的结果与现实世界中的治疗效果之间存在巨大差距。用于治疗nAMD的新型药物可能具有改善治疗效果和减少频繁玻璃体内注射治疗的潜力。我们总结了所有更新的分子、它们的关键临床试验结果及其独特的作用机制；这些包括长效药物、联合策略、缓释制剂和基因疗法。
