Recent Developments in the Treatment of Wet Age-related Macular Degeneration

Papadopoulos, Zois

doi:10.1007/s11596-020-2253-6

Cited by 23 publications

(16 citation statements)

References 29 publications

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“…Current treatment strategies for neovascular macular degeneration (AMD) markedly improve visual outcomes (Brynskov et al 2020, Papadopoulos 2020, but often require close monitoring and administration of anti-VEGF injections for extended periods of time (Baek et al 2019). Together with the demographic transition to an older population, this will continue to be the main driving force behind the rise in the number of patients in need of treatment (Potapenko & la Cour 2021), increasing the burden on ophthalmology services.…”

Section: Introductionmentioning

confidence: 99%

Automated artificial intelligence‐based system for clinical follow‐up of patients with age‐related macular degeneration

Potapenko

Thiesson

Kristensen³

et al. 2022

Acta Ophthalmologica

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Purpose: In this study, we investigate the potential of a novel artificial intelligence-based system for autonomous follow-up of patients treated for neovascular age-related macular degeneration (AMD). Methods: A temporal deep learning model was trained on a data set of 84 489 optical coherence tomography scans from AMD patients to recognize disease activity, and its performance was compared with a published non-temporal model trained on the same data (Acta Ophthalmol, 2021). An autonomous follow-up system was created by augmenting the AI model with deterministic logic to suggest treatment according to the observe-and-plan regimen. To validate the AI-based system, a data set comprising clinical decisions and imaging data from 200 follow-up consultations was collected prospectively. In each case, both the autonomous AI decision and original clinical decision were compared with an expert panel consensus. Results: The temporal AI model proved superior at detecting disease activity compared with the model without temporal input (area under the curve 0.900 (95% CI 0.894-0.906) and 0.857 (95% CI 0.846-0.867) respectively). The AIbased follow-up system could make an autonomous decision in 73% of the cases, 91.8% of which were in agreement with expert consensus. This was on par with the 87.7% agreement rate between decisions made in the clinic and expert consensus (p = 0.33). Conclusions: The proposed autonomous follow-up system was shown to be safe and compliant with expert consensus on par with clinical practice. The system could in the future ease the pressure on public ophthalmology services from an increasing number of AMD patients.

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Section: Introductionmentioning

confidence: 99%

Automated artificial intelligence‐based system for clinical follow‐up of patients with age‐related macular degeneration

Potapenko

Thiesson

Kristensen³

et al. 2022

Acta Ophthalmologica

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“…The symptoms in patients with exudative AMD are practically nonexistent, and sometimes only mild symptoms are reported—e.g., loss of central visual acuity, disturbances in contrast or colors, and distorted vision or mild metamorphopsia [ 67 ]. The localization of the atrophy is important for rating the gravity of the symptoms.…”

Section: Exudative Age-related Macular Degeneration (Wet Amd)mentioning

confidence: 99%

Exudative versus Nonexudative Age-Related Macular Degeneration: Physiopathology and Treatment Options

Fernandes

Zielińska

Santos

et al. 2022

IJMS

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Age-related macular degeneration (AMD) is an eye disease typically associated with the aging and can be classified into two types—namely, the exudative and the nonexudative AMD. Currently available treatments for exudative AMD use intravitreal injections, which are associated with high risk of infection that can lead to endophthalmitis, while no successful treatments yet exist for the nonexudative form of AMD. In addition to the pharmacologic therapies administered by intravitreal injection already approved by the Food and Drug Administration (FDA) in exudative AMD, there are some laser treatments approved that can be used in combination with the pharmacological therapies. In this review, we discuss the latest developments of treatment options for AMD. Relevant literature available from 1993 was used, which included original articles and reviews available in PubMed database and also information collected from Clinical Trials Gov website using “age-related macular degeneration” and “antiangiogenic therapies” as keywords. The clinical trials search was limited to ongoing trials from 2015 to date.

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“…Currently, there are alternative intraocular injections with respect to the location and drug being delivered that might be more useful [140]. These alternatives include sub-conjunctival injection and parabulbar injection, which take place underneath the conjunctiva for trans-scleral delivery [141]. Practically, a sustained in vivo drug release for up to 4 weeks was shown following sub-conjunctival injection of dorzolamide-loaded polymer disks [142].…”

Section: Alternative Injection Locationsmentioning

confidence: 99%

Intravitreal Injectable Hydrogels for Sustained Drug Delivery in Glaucoma Treatment and Therapy

Akulo¹,

Adalı

Moyo³

et al. 2022

Polymers

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Glaucoma is extensively treated with topical eye drops containing drugs. However, the retention time of the loaded drugs and the in vivo bioavailability of the drugs are highly influenced before reaching the targeted area sufficiently, due to physiological and anatomical barriers of the eye, such as rapid nasolacrimal drainage. Poor intraocular penetration and frequent administration may also cause ocular cytotoxicity. A novel approach to overcome these drawbacks is the use of injectable hydrogels administered intravitreously for sustained drug delivery to the target site. These injectable hydrogels are used as nanocarriers to intimately interact with specific diseased ocular tissues to increase the therapeutic efficacy and drug bioavailability of the anti-glaucomic drugs. The human eye is very delicate, and is sensitive to contact with any foreign body material. However, natural biopolymers are non-reactive, biocompatible, biodegradable, and lack immunogenic and inflammatory responses to the host whenever they are incorporated in drug delivery systems. These favorable biomaterial properties have made them widely applicable in biomedical applications, with minimal adversity. This review highlights the importance of using natural biopolymer-based intravitreal hydrogel drug delivery systems for glaucoma treatment over conventional methods.

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Recent Developments in the Treatment of Wet Age-related Macular Degeneration

Cited by 23 publications

References 29 publications

Automated artificial intelligence‐based system for clinical follow‐up of patients with age‐related macular degeneration

Automated artificial intelligence‐based system for clinical follow‐up of patients with age‐related macular degeneration

Exudative versus Nonexudative Age-Related Macular Degeneration: Physiopathology and Treatment Options

Intravitreal Injectable Hydrogels for Sustained Drug Delivery in Glaucoma Treatment and Therapy

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