Liakopoulos Sandra, von der Emde Leon, Biller Marvin L, Ach Thomas, Holz Frank G
Department of Ophthalmology, Cologne Image Reading Center (CIRCL), University of Cologne, Cologne, Germany; Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany; Department of Ophthalmology, University of Bonn, Bonn, Germany; GRADE Reading Center, Bonn.
Dtsch Arztebl Int. 2025 Feb 7;122(3):82-88. doi: 10.3238/arztebl.m2025.0003.
Age-related macular degeneration (AMD), a condition of multifactorial origin, is a major cause of irreversible vision loss in industrialized countries. The dry late stage of the disease, known as geographic atrophy (GA), is characterized by progressive loss of photoreceptor cells and retinal pigment epithelial cells in the central retina. An estimated 300 000 to 550 000 people in Germany suffer from GA.
This review is based on pertinent literature retrieved by a selective search in the PubMed and Web of Science databases.
In 2023, the complement inhibitors pegcetacoplan and avacincaptad pegol were approved in the USA for repeated intravitreal injections and thereby became the first drugs ever approved for the treatment of GA. In Europe, the marketing authorization application for both drugs was withdrawn by the manufacturers after a negative judgment was expressed by the European Medicines Agency (EMA) Committee for Medicinal Products for Human Use (CHMP). The EMA stated that the significant slowing of atrophy progression that had been achieved in the approval trials did not lead to any clinically relevant functional benefit for the patients. Further treatment approaches, including gene therapy, are now being studied in clinical trials. There is evidence that micronutrients may slow the progression of atrophy.
In Europe at present, there is no approved treatment for GA due to AMD. There is thus a continuing need for preventive and rehabilitative measures such as smoking cessation, a balanced diet, and magnifying visual aids for patients in the advanced stages of the disease.
年龄相关性黄斑变性（AMD）是一种多因素起源的疾病，是工业化国家不可逆视力丧失的主要原因。该疾病的干性晚期，即地图样萎缩（GA），其特征是中央视网膜中的光感受器细胞和视网膜色素上皮细胞逐渐丧失。德国估计有30万至55万人患有GA。
本综述基于在PubMed和Web of Science数据库中通过选择性检索获得的相关文献。
2023年，补体抑制剂聚乙二醇西妥昔单抗和阿伐西普妥单抗在美国被批准用于重复玻璃体内注射，从而成为有史以来首批被批准用于治疗GA的药物。在欧洲，在欧洲药品管理局（EMA）人用药品委员会（CHMP）做出负面判断后，这两种药物的制造商撤回了上市许可申请。EMA表示，在批准试验中实现的萎缩进展显著减缓并未给患者带来任何临床相关的功能益处。目前正在临床试验中研究包括基因治疗在内的进一步治疗方法。有证据表明，微量营养素可能会减缓萎缩的进展。
目前在欧洲，尚无因AMD导致的GA的获批治疗方法。因此，对于疾病晚期的患者，持续需要采取戒烟、均衡饮食和放大视觉辅助工具等预防和康复措施。
