Exudative Age-Related Macular Degeneration: Current Therapies and Potential Treatments

2009 ◽  
Vol 1 ◽  
pp. CMT.S2225
Author(s):  
Polly A. Quiram ◽  
Yahui Song
Keyword(s):  
Macular Degeneration ◽  
Vision Loss ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Optimal Dosing ◽  
Dosing Strategies ◽  
Current Therapies ◽  
History Of ◽  
First Time ◽  
Harmful Effects

Strategies for preventing vision loss in patients with neovascular age-related macular degeneration (ARMD) have evolved over the past decade. Whereas earlier treatments were based on thermal destruction of choroidal neovascularization (CNV), new therapies rely on targeted pharmacologic approaches to reduce the harmful effects of CNV treatment. For the first time in the history of neovascular ARMD treatment, anti-VEGF therapies have consistently improved visual acuity in a subset of patients. Clinical trials continue to investigate the optimal dosing strategies and combination therapies to better refine the treatment of this chronic and debilitating disease.

scholarly journals Current and upcoming anti-VEGF therapies and dosing strategies for the treatment of neovascular AMD: a comparative review

2019 ◽  
Vol 4 (1) ◽  
pp. e000398 ◽  
Author(s):  
Saira Khanna ◽  
Rahul Komati ◽  
David A Eichenbaum ◽  
Ishani Hariprasad ◽  
Thomas A Ciulla ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Vision Loss ◽  
Disease Process ◽  
Age Related Macular Degeneration ◽  
Anti Vegf ◽  
Age Related ◽  
Optimal Dosing ◽  
Comparative Review ◽  
Dosing Strategies ◽  
Endothelial Growth Factor

Age-related macular degeneration is the leading cause of vision loss in the developed world, with the expected number of affected elderly individuals reaching 17.8 million. Antivascular endothelial growth factor (anti-VEGF) injection therapy has been instrumental in treating a disease process that was previously thought to be untreatable. Over the past two decades, landmark studies have demonstrated the efficacy of different anti-VEGF medications and investigated the optimal dosing regimen and delivery mechanism to increase overall vision and minimise patient burden. In this review, we outline landmark neovascular age-related macular degeneration clinical trials that have demonstrated level 1 evidence for its usage or have contributed to the understanding of how to dose these agents.

scholarly journals History and Basic Principles of Photodynamic Therapy Use in Ophthalmology

2021 ◽  
Vol 5 (1) ◽  
pp. 168-176
Author(s):  
Abdul Karim Ansyori
Keyword(s):  
Photodynamic Therapy ◽  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Pathological Myopia ◽  
Basic Principles ◽  
Age Related ◽  
Photosensitizing Agents ◽  
History Of ◽  
First Time ◽  
Photodynamic Reaction

Photodynamic therapy (PDT) is a therapy that uses drugs, called photosensitizers or photosensitizing agents, and a specific type of light. When photosensitizers are exposed to certain wavelengths of light, they produce oxygen that kills nearby cells. PDT is achieved by a photodynamic reaction induced by the excitation of a photosensitizer exposed to light. In the field of ophthalmology, PDT was approved for the first time about ten years ago for cases of age-related macular degeneration (AMD). Neovascular age-related macular degeneration (AMD) is a vision-threatening disease characterized by pathological macular neovascularization. After that, PDT was approved for use in choroidal neovascularization (CNV) cases in pathological myopia.3 This literature review aims to describe the history of PDT use and the basic principles of photodynamic therapy in ophthalmology.

scholarly journals Principles of anti-VEGF dosing in the treatment of neovascular age-related macular degeneration

2019 ◽  
Vol 12 (3) ◽  
pp. 102-112
Author(s):  
I. E. Ioshin ◽  
T. Anoprieva
Keyword(s):  
Macular Degeneration ◽  
Vision Loss ◽  
Evidence Base ◽  
Age Related Macular Degeneration ◽  
Neovascular Amd ◽  
Anti Vegf ◽  
Age Related ◽  
Optimal Dosing ◽  
Increased Risk ◽  
Dosing Regimens

Age-related macular degeneration (AMD) is a chronic progressive disease regarded as a leading cause of vision impairment in elderly people in industrial countries. Neovascular AMD is characterized by an increased risk of severe vision loss. Intravitreal injections of anti-VEGF medication has become a standard of treatment of neovascular AMD. Clinical trials demonstrate that the use of anti-VEGF helps stabilize the vision in at least 90 % of patients, while 30 to 40 % gain three or more lines of vision (15 ETDRS letters). However, observational studies suggest that there are barriers diminishing the efficacy of anti-VEGF treatment in routine clinical practice. Finding an optimal dosing regimen for anti-VEGF therapy that could maintain treatment efficacy with a lower number of injections and fewer monitoring visits could be a solution. The review discusses the evidence base regarding anti-VEGF dosing principles and analyzes current dosing regimens with regard to their benefits and limitations.

scholarly journals PREVALENSI AGE RELATED MACULAR DEGENERATION DI POLIKLINIK MATA BLU RSUP Prof. Dr. R. D. KANDOU MANADO PERIODE JANUARI 2013 – OKTOBER 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Clarissa E. Tany ◽  
Vera Sumual ◽  
J. S. M. Saerang
Keyword(s):  
Retrospective Study ◽  
Macular Degeneration ◽  
Medical Records ◽  
Vision Loss ◽  
Central Area ◽  
Age Related Macular Degeneration ◽  
Common Cause ◽  
Age Related ◽  
History Of ◽  
Male Patients

Abstract: Age–related macular degeneration (AMD) is a visual impairment in central area of the retina (macula) that tends to be progressive. In developing countries, AMD becomes the most common cause of irreversible vision loss in people aged ≥50 years. This study aimed to obtain the prevalence of AMD in Department of Opthalmology at Prof. Dr. R. D. Kandou Hospital Manado from January 2013 to October 2015. This was a descriptive retrospective study using medical records of Department of Opthalmology. The results showed that there were 41 patients diagnosed as AMD. Based on sexes, AMD occured more frequent in male patients as many as 28 paients (68.3%). This disease was dominated by patients aged 61-70 years old as many as 16 patients (39%). There were 10 patients (24.4%) that had history of hypertension.Keywords: prevalence, AMD  Abstrak: Age–related macular degeneration (AMD) adalah suatu gangguan penglihatan sentral retina (makula) yang bersifat progresif. Di negara berkembang AMD menjadi penyebab terbanyak hilangnya penglihatan yang ireversibel pada individu di atas 50 tahun. Penelitian ini bertujuan untuk mengetahui prevalensi AMD di Poliklinik Mata BLU RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2013-Oktober 2015. Jenis penelitian ini deskriptif retrospektif dengan memanfaatkan data rekam medik di Poliklinik Mata BLU RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian memperlihatkan 41 pasien dengan diagnosis AMD. Berdasarkan jenis kelamin, AMD lebih banyak dialami oleh jenis kelamin laki-laki sebanyak 28 orang (68,3%), sedangkan untuk rentang umur didominasi oleh umur 61-70 tahun yaitu sebanyak 16 orang (39%). Terdapat 10 orang (24,4%) dengan riwayat hipertensi.Kata kunci: prevalensi, AMD

scholarly journals Role of amyloid β-peptide in the pathogenesis of age-related macular degeneration

2021 ◽  
Vol 6 (1) ◽  
pp. e000774
Author(s):  
Minwei Wang ◽  
Shiqi Su ◽  
Shaoyun Jiang ◽  
Xinghuai Sun ◽  
Jiantao Wang
Keyword(s):  
Mitochondrial Dysfunction ◽  
Macular Degeneration ◽  
Vision Loss ◽  
Cell Structure ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Amyloid Β ◽  
Age Related Macular Degeneration ◽  
Amyloid Β Peptide ◽  
Age Related

Age-related macular degeneration (AMD) is the most common eye disease in elderly patients, which could lead to irreversible vision loss and blindness. Increasing evidence indicates that amyloid β-peptide (Aβ) might be associated with the pathogenesis of AMD. In this review, we would like to summarise the current findings in this field. The literature search was done from 1995 to Feb, 2021 with following keywords, ‘Amyloid β-peptide and age-related macular degeneration’, ‘Inflammation and age-related macular degeneration’, ‘Angiogenesis and age-related macular degeneration’, ‘Actin cytoskeleton and amyloid β-peptide’, ‘Mitochondrial dysfunction and amyloid β-peptide’, ‘Ribosomal dysregulation and amyloid β-peptide’ using search engines Pubmed, Google Scholar and Web of Science. Aβ congregates in subretinal drusen of patients with AMD and participates in the pathogenesis of AMD through enhancing inflammatory activity, inducing mitochondrial dysfunction, altering ribosomal function, regulating the lysosomal pathway, affecting RNA splicing, modulating angiogenesis and modifying cell structure in AMD. The methods targeting Aβ are shown to inhibit inflammatory signalling pathway and restore the function of retinal pigment epithelium cells and photoreceptor cells in the subretinal region. Targeting Aβ may provide a novel therapeutic strategy for AMD.

scholarly journals Incidence of elevated intraocular pressure after intravitreal injection in Japanese patients with age-related macular degeneration

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maiko Maruyama-Inoue ◽  
Tatsuya Inoue ◽  
Shaheeda Mohamed ◽  
Yoko Kitajima ◽  
Shoko Ikeda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intraocular Pressure ◽  
Macular Degeneration ◽  
Intravitreal Injection ◽  
Odds Ratio ◽  
Japanese Patients ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
Elevated Intraocular Pressure ◽  
History Of

AbstractThe purpose of this study was to report the incidence of elevated intraocular pressure (IOP) after intravitreal injection (IVI) of anti-vascular endothelial growth factor (VEGF) in Japanese patients with age-related macular degeneration (AMD). A retrospective study of chart review of patients who underwent ≥ 10 intravitreal anti-VEGF injections between April 2009 and December 2019 was conducted. Elevated IOP was defined as IOP ≥ 25 mmHg at one visit. Cases with elevated IOP resulting from IVI were identified. Furthermore, the association between elevated IOP and some parameters, as the risk factors that influence elevated IOP, was investigated. A total of 402 eyes of 370 patients were included in this study. Twenty-eight eyes of 26 patients (7.0%) were identified as cases with elevated IOP after IVI. The mean time of elevation after baseline was 50.6 ± 26.5 months. History of glaucoma (p = 0.021; odds ratio, 5.85), treatment modality (p = 0.019; odds ratio, 6.32), and total number of injections (p = 0.003; odds ratio, 1.03) were significantly associated with elevated IOP. A late complication of elevated IOP is associated with IVI in patients with AMD. Particularly, history of glaucoma and treat and extend regimen with frequent injections were found to be risk factors of elevated IOP.

scholarly journals Mingjing granule, a traditional Chinese medicine in the treatment of neovascular age-related macular degeneration: study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yamin Li ◽  
Lina Liang ◽  
Torkel Snellingen ◽  
Kai Xu ◽  
Yun Gao ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Macular Degeneration ◽  
Vision Loss ◽  
Age Related Macular Degeneration ◽  
Case Report Form ◽  
Link Type ◽  
Anti Vegf ◽  
Age Related ◽  
Function Test

Abstract Background Neovascular age-related macular degeneration (nAMD) is the most common cause of irreversible vision loss and blindness among the older people aged 50 and over. Although anti-vascular endothelial growth factor (anti-VEGF) therapies have resulted in improving patient outcomes, there are limitations associated with these treatments. In China, traditional Chinese medicine (TCM) has been used to treat eye diseases for more than 2000 years. Previous studies have shown that TCM may be beneficial for nAMD patients. However, explicit evidence has not been obtained. The purpose of the present trial is to examine the efficacy and safety of the Mingjing granule, a compound Chinese herbal medicine, for nAMD patients. Methods/design This is a double-blind, placebo-controlled, randomized trial of Mingjing granule as an add-on to intravitreous ranibizumab for nAMD. One hundred eighty nAMD patients from six hospitals in China will be enrolled according to the inclusion and exclusion criteria and randomly allocated into two groups, 90 in each. All participants will receive a 24-week treatment and then be followed up for another 24 weeks. The primary outcome is the mean change of best-corrected visual acuity at week 24 and 48 as compared to the baseline. The secondary outcomes include mean change in central retinal thickness, area of retinal hemorrhage and exudation, and TCM syndrome score, mean number of intravitreal ranibizumab injection, and total cost of the treatment. Indexes of safety include blood regular test, urine regular test, liver function test, renal function test, and electrocardiogram from baseline to weeks 24 and 48. Qualitative control and some standard operating processes will be formed throughout the trial. Any ocular or systemic adverse events will be treated suitably, and related data will be recorded accurately and completely in the case report form. Discussion Based on previous empirical and animal laboratory studies, this study will address the question of whether Mingjing granule could contribute to improving efficacy, safety, and efficiency with need for fewer intravitreal injections of anti-VEGF, improving compliance and visual outcomes in the management of persons with nAMD. Trial registration Chinese Clinical Trial Registry (http://www.chictr.org.cn), ChiCTR2000035990. Registered on 21 August 2020.

HISTORY OF SUNLIGHT EXPOSURE IS A RISK FACTOR FOR AGE-RELATED MACULAR DEGENERATION

Retina ◽  
2016 ◽  
Vol 36 (4) ◽  
pp. 787-790 ◽  
Author(s):  
Tina Schick ◽  
Lebriz Ersoy ◽  
Yara T. E. Lechanteur ◽  
Nicole T. M. Saksens ◽  
Carel B. Hoyng ◽  
...  
Keyword(s):  
Risk Factor ◽  
Macular Degeneration ◽  
Sunlight Exposure ◽  
Age Related Macular Degeneration ◽  
Age Related ◽  
History Of

scholarly journals Dietary Lutein, Zeaxanthin and Omega-3- Essential Fatty Acid Intake and Risk of Age-Related Macular Degeneration in a Selected Australian Population

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 111-111
Author(s):  
Kingsley Kalu ◽  
Angelica Ly ◽  
Charles McMonnies ◽  
Jayashree Arcot
Keyword(s):  
Fatty Acid ◽  
Family History ◽  
Macular Degeneration ◽  
South Asian ◽  
Middle Eastern ◽  
Age Related Macular Degeneration ◽  
Dietary Intakes ◽  
Omega 3 ◽  
Age Related ◽  
History Of

Abstract Objectives The aim of this study was to assess the dietary intakes of lutein, zeaxanthin (L + Z) and omega-3-essential fatty acid(EFA) among a selected population of Australian based adults and to examine the effect of specified risk factors for age-related macular degeneration(AMD) on those levels. Methods A cross-sectional study involving 70 adults aged 19–52 years was carried out. Demographic data were obtained using an online self-administered questionnaire while dietary intakes were estimated using USDA's 24 hours recall questionnaire, the Victorian Cancer Council(Australia) food frequency questionnaire and anthropometric characteristics were obtained using a body composition analyzer. Dietary intakes of lutein, zeaxanthin, omega-3-EFA and anthropometric indices against the risk of AMD were established using descriptive statistics and Spearman correlation. Results The mean age of the population was 29.9 ± 8.1years with 51% men and 49% women. Women had a higher intake of L + Z (1908.6 μg/day versus 1032.8 μg/day) and alpha-linolenic acid(ALA) compared to men(1.7 ± 1.1 g/day versus 1.6 ± 1.2 g/day). Men consumed more omega-3-EFA than women (433 ± 397.1 mg/day versus 365 ± 210.7 mg/day). L + Z levels were higher among people of Middle Eastern and South Asian origin (>4000 μg/day) in the 19–25years age group. People of Middle Eastern, South East Asian and South Asian had the highest intake of omega-3-EFA(>500 mg/day) at ages 19–25, 26–32 and 34–52years respectively. Women aged 34–52years with a family history of AMD had higher levels of L + Z(>2500 μg/day) while women aged 26–32years with a family history of AMD had higher levels of ALA(>3 g/day). Ethnicity and L + Z were correlated (P = −0.456, P < 0.02). Higher levels of intake of L + Z (>4000 μg/day) were seen in participants aged 34–52years with a 5–10years residence in Australia. Participants who had less than 5–10years of residency had higher levels of omega-3-EFA(>500 mg/day) for ages 26–32years while those aged 34–52years who had less than 5years of residency had higher ALA(>4 g/day). Conclusions Intake levels for L + Z vary significantly among participants. Culturally specific dietary habits could feasibly influence the levels of intake of L + Z. Intake levels of omega-3-EFA were met. This study provides detailed intake levels of L + Z and omega-3-EFA for the ‘at-risk’ AMD group. Funding Sources No funding source.

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