Emerging therapies and their delivery for treating age‐related macular degeneration

Thomas, Clare E.; Sim, Dawn A; Lee, Wen‐Hwa; Alfahad, Nada; Dick, Andrew D.; Denniston, Alastair K; Hill, Lisa J

doi:10.1111/bph.15459

Cited by 28 publications

(25 citation statements)

References 132 publications

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“…Currently, intravitreal injection of anti-VEGF drugs is the standard treatment for neovascular ARMD. Patients with neovascular ARMD require long-term repeated intravitreal injections during anti-VEGF therapy [ 4 , 13 ]. Repeated injections may lead to complications such as uveitis, endophthalmitis, subconjunctival haemorrhage, elevated intraocular pressure, retinal detachment, retinal pigment epithelium tears, corneal nerve fibres and sensitivity loss [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

The effect of vitreomacular interface in neovascular age-related macular degeneration treated with intravitreal injection of anti-VEGF

et al. 2022

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Background The purpose of this study is to study the effect of repeated intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) drugs on vitreomacular interface. Methods Neovascular age-related macular degeneration patients who received intravitreal injections of anti-VEGF drugs were included. Eyes with severe vitreous opacity, uveitis, complicated cataract surgery and previous vitrectomy were excluded. Vitreomacular interface, best corrected visual acuity (BCVA) and central retinal thickness (CRT) assessment were performed once a month for at least 3 months. The nature and time of the change event are recorded. Groups were divided according to whether vitreomacular interface change events occurred. To analyse the risk factors of vitreomacular interface changes and their influence on treatment effect. Results A total of 87 eyes were evaluated. Vitreomacular interface change event occurred in 9 eyes. Pre-existing vitreomacular interface abnormality (VMIA) was a risk factor for the VMI change (P = 0.033, OR = 16.518, 95% CI: 1.258 to 216.939). 60% of interface events occurred in the first 3 months of treatment. The final BCVA of eyes with vitreomacular interface unchanged was significantly higher than that at baseline (P = 0.001), and the final CRT was also significantly lower than that at baseline (P < 0.001). The final CRT of eyes vitreomacular interface changed was significantly lower than that at baseline (P = 0.015), however, there was no statistical significance in BCVA (P = 0.468). Conclusion Intravitreal injection of anti-VEGF drugs has a certain probability to cause changes in the vitreomacular interface, and the risk is higher in eyes with pre-existing vitreomacular interface abnormality. The effect of intravitreal injections on the vitreomacular interface was concentrated in the first three injections, and subsequent increases in the number of injections did not significantly increase the risk of vitreomacular interface abnormality. Ophthalmologists should increase attention to the vitreomacular interface in the early stages of anti-VEGF therapy and counsel patients accordingly.

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Section: Discussionmentioning

confidence: 99%

The effect of vitreomacular interface in neovascular age-related macular degeneration treated with intravitreal injection of anti-VEGF

et al. 2022

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“…Russ et al have shown that a single topical delivery of GAL-101, a small molecule inhibitor of Aβ, sustained concentrations >100 nm in the retina of monkeys for >2 h. Daily eye drops in a glaucoma rat model achieved >90% neuroprotection [102]. Phase I trials for geographic atrophy have successfully been completed [110].…”

Section: Innovative Small Moleculesmentioning

confidence: 99%

“…In a Phase II trial (NCT01678963), this formulation, with improved trans-scleral permeability and increased choroidal retention, showed a trend towards better visual acuity in patients with all types of naïve neovascular lesions. Subsequent Phase III trials (NCT02727881) failed to meet the primary endpoint [110].…”

Section: Innovative Small Moleculesmentioning

confidence: 99%

Topical Drug Delivery to the Posterior Segment of the Eye

et al. 2022

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Topical drug delivery to the posterior segment of the eye is a very complex challenge. However, topical delivery is highly desired, to achieve an easy-to-use treatment option for retinal diseases. In this review, we focus on the drug characteristics that are relevant to succeed in this challenge. An overview on the ocular barriers that need to be overcome and some relevant animal models to study ocular pharmacokinetics are given. Furthermore, a summary of substances that were able to reach the posterior segment after eye drop application is provided, as well as an outline of investigated delivery systems to improve ocular drug delivery. Some promising results of substances delivered to the retina suggest that topical treatment of retinal diseases might be possible in the future, which warrants further research.

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“…Two of the articles included in this collection have the impact of ageing on vision as their focus. In their review, ‘emerging therapies and their delivery for treating age‐related macular degeneration’, Thomas et al ( 2022 ) describe age‐related macular degeneration (AMD), the most common cause of blindness in the Western world. With new therapeutic strategies emerging for AMD, novel delivery routes and their implications for translation into clinical practice are critical factors in determining their future success.…”

Section: Linked Articlesmentioning

confidence: 99%