A Review of Macular Atrophy of the Retinal Pigment Epithelium in Patients with Neovascular Age-Related Macular Degeneration: What is the Link? Part II

Horani, Mania; Mahmood, Sajjad; Aslam, Tariq

doi:10.1007/s40123-019-00227-8

Cited by 7 publications

(6 citation statements)

References 95 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…While the use of anti-VEGF therapies has revolutionized the treatment of ocular neovascularization, anti-VEGF therapy could potentially lead to retinal atrophy, and blockage of VEGF-A during retinal stress could lead to accelerated retinal cell death and is an area of active investigation. [3][4][5][6][7][8][9][10][11][12] In addition, 15%-40% of eyes fail to or only partially respond to anti-VEGF therapies. 13 Further, anti-VEGF therapy involves frequent, often monthly, intravitreal injections of anti-VEGF agents, which are costly and inconvenient for patients, and carry a risk of eye infection or endophthalmitis.…”

Section: Introductionmentioning

confidence: 99%

“…Treatment of RNV includes anti‐vascular endothelial growth factor (VEGF) therapy and laser therapy. While the use of anti‐VEGF therapies has revolutionized the treatment of ocular neovascularization, anti‐VEGF therapy could potentially lead to retinal atrophy, and blockage of VEGF‐A during retinal stress could lead to accelerated retinal cell death and is an area of active investigation 3–12 . In addition, 15%–40% of eyes fail to or only partially respond to anti‐VEGF therapies 13 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Photo‐mediated ultrasound therapy for the treatment of retinal neovascularization in rabbit eyes

Yoshida

et al. 2022

Lasers Surg Med

View full text Add to dashboard Cite

Objectives: Retinal neovascularization (RNV) is the growth of abnormal microvessels on the retinal surface and into the vitreous, which can lead to severe vision loss. By combining relatively low-intensity ultrasound and nanosecond-pulse-duration laser, we developed a novel treatment method, namely photo-mediated ultrasound therapy (PUT), which holds a potential to remove RNV with minimal or no damage to the adjacent tissues. Methods: RNV was created in both albino and pigmented rabbits (n = 10) through a single intravitreal injection with DL-α-aminoadipic acid. RNV was treated with PUT 8 weeks postinjection. After PUT treatment, animals were evaluated longitudinally for up to 6 weeks. Treatment outcomes were evaluated through fundus photography, red-free fundus photography, fluorescein angiography (FA), and histopathology. Results: In both albino and pigmented rabbits, there were no leakage in the treatment area immediately after PUT treatment as demonstrated by FA, indicating the cessation of blood perfusion of the RNV in the treated area. The fluorescence leakage did not recover in albino rabbits during the 6-week posttreatment monitoring period, and only 9.9 ± 9.8% of the neovascularization remained at the end of 6 weeks. In the pigmented rabbits, the fluorescence leakage partially returned, but the level of leakage decreased over time during the 6-week posttreatment monitoring period, and only 10.8 ± 9.8% of the neovascularization remained at the end of 6 weeks. Histology demonstrated removal of vasculature without damage to the surrounding neurosensory retina. Conclusions: These results demonstrate that PUT could precisely remove RNV without damage to the surrounding neurosensory retina in both rabbit strains.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Photo‐mediated ultrasound therapy for the treatment of retinal neovascularization in rabbit eyes

Yoshida

et al. 2022

Lasers Surg Med

View full text Add to dashboard Cite

show abstract

“…On the contrary, recent evidence suggests that type 1 NV could act as a protective factor against the development of RPE atrophy, which is supported by the hypothesis that the RPE and the photoreceptors obtain some nutritional support from the neovascular tissue underneath the RPE in type 1 NV (Horani et al 2020). Actually, a recent clinicopathologic study demonstrated that in patients with non‐exudative type 1 NV, outer retinal structure was supported for 9 years and the visual acuity was preserved, which suggests that type 1 NV could nourish RPE and help preserve the outer retina without exudative change (Chen et al 2020).…”

Section: Discussionmentioning

confidence: 96%

Progression of macular atrophy in patients undergoing anti‐vascular endothelial growth factor therapy for neovascular age‐related macular degeneration

Cho

Park

Kim

et al. 2020

Acta Ophthalmologica

View full text Add to dashboard Cite

Purpose To assess differences in the progression of macular atrophy (MA) between neovascular age‐related macular degeneration (AMD) subtypes and to identify the risk factors associated with the foveal involvement among patients with MA undergoing long‐term anti‐vascular endothelial growth factor (VEGF) treatment. Methods Eighty eyes of 80 patients with neovascular AMD who developed incident MA following anti‐VEGF therapy were retrospectively included. Macular atrophy (MA) was quantified using autofluoresence (AF) images within 24 months after the onset of MA, and the enlargement rate was compared between neovascular AMD subtypes. Regression models were constructed to explore relationships between foveal involvement in MA and baseline characteristics. Results The growth rate of MA was 0.18 mm2/year for type 1 neovascularization (NV), 0.24 mm2/year for type 2 NV, and 1.21 mm2/year for type 3 NV; differences between groups were significant (p = 0.022). Multivariate logistic regression analysis revealed that thin subfoveal choroidal thickness (p = 0.028), presence of subretinal drusenoid deposit (p = 0.005), type 2 or 3 NV (p = 0.023), and geographic atrophy in the fellow eye (p = 0.035) were significant risk factors for MA with foveal involvement. The number of injections showed no significant association with the progression or the foveal involvement in MA. Conclusions The progression of MA in patients with neovascular AMD undergoing anti‐VEGF treatment differed significantly depending on the subtype of neovascularization. The risk of foveal involvement in MA was associated with the baseline factors or phenotype of neovascular AMD rather than with injection frequency of anti‐VEGF.

show abstract

“…There has been discussion of emerging evidence suggesting that anti-VEGF treatment may play a role in the development of MA in some patients [26,30,[35][36][37][38][39]. As there are no effective treatments for MA [25], this can lead to irreversible vision loss.…”

Section: Anti-vegf Treatmentmentioning

confidence: 99%

Development of Macular Atrophy in Patients with Wet Age-Related Macular Degeneration Receiving Anti-VEGF Treatment

et al. 2021

View full text Add to dashboard Cite

Age-related macular degeneration (AMD) is a leading cause of blindness. Late AMD can be classified into exudative (commonly known as wet AMD [wAMD]) or dry AMD, both of which may progress to macular atrophy (MA). MA causes irreversible vision loss and currently has no approved pharmacological treatment. The standard of care for wAMD is treatment with anti-vascular endothelial growth factors (VEGF). However, recent evidence suggests that anti-VEGF treatment may play a role in the development of MA. Therefore, it is important to identify risk factors for the development of MA in patients with wAMD. For example, excessive blockade of VEGF through intense use of anti-VEGF agents may accelerate the development of MA. Patients with type III macular neovascularisation (retinal angiomatous proliferation) have a particularly high risk of MA. These patients are characterised as having a pre-existing thin choroid (age-related choroidopathy), suggesting that the choroidal circulation is unable to respond to increased VEGF expression. Evidence suggests that subretinal fluid (possibly indicative of residual VEGF activity) may play a protective role. Patients receiving anti-VEGF agents must be assessed for overall risk of MA and there is an unmet medical need to prevent the development of MA without undertreating wAMD.

show abstract

A Review of Macular Atrophy of the Retinal Pigment Epithelium in Patients with Neovascular Age-Related Macular Degeneration: What is the Link? Part II

Cited by 7 publications

References 95 publications

Photo‐mediated ultrasound therapy for the treatment of retinal neovascularization in rabbit eyes

Photo‐mediated ultrasound therapy for the treatment of retinal neovascularization in rabbit eyes

Progression of macular atrophy in patients undergoing anti‐vascular endothelial growth factor therapy for neovascular age‐related macular degeneration

Development of Macular Atrophy in Patients with Wet Age-Related Macular Degeneration Receiving Anti-VEGF Treatment

Contact Info

Product

Resources

About