The Impact of the Macular Photocoagulation Study Results on the Treatment of Exudative Age-Related Macular Degeneration

EIAV vector-mediated delivery of endostatin or angiostatin inhibits angiogenesis and vascular hyperpermeability in experimental CNV

“…1,3 These treatments are ablative in nature, result in only modest slowing of disease progression, have a significant incidence of recurrences and typically require repeated administration as they do not directly address the underlying pro-angiogenic stimuli. [3][4][5] An improved understanding of the molecular mechanisms involved in angiogenesis is currently facilitating the development of novel biological and pharmacological therapies designed to arrest progression or induce regression of neovascularisation by redressing the imbalance between angiogenic and angiostatic stimuli. Intraocular delivery is an attractive route of administration for such therapies since it is likely to minimise potential systemic adverse effects of antiangiogenic agents that may be particularly relevant to the elderly population already at risk of vascular disease.…”

Benzoporphyrin (verteporfin) photodynamic therapy for choroidal neovascularization in age-related macular degeneration

“…Unfortunately, the majority of the patients, up to 87% of them, with newly diagnosed neovascular AMD accordingly to Freund et al 26 , do not meet the criteria for laser photocoagulation because the CNV is too large, occult or ill defined 14,15,27,28 . Furthermore, among those patients with extrafoveal lesion treated with laser photocoagulation, up to 54% suffered recurrence (defined by leakage of fluorescein at the periphery of the laser scar later than 6 weeks after treatment) after a 5-year follow-up 18, 30, 31. In the juxtafoveal and subfoveal groups of patients similarly recurrence occurred in 47 and 35% respectively 27,32,34 . Nowadays, it is becoming evident that the available techniques for laser photocoagulation of choroidal neovascular membranes due to AMD will not have a major impact on blindness due to AMD, despite early expectations 24,27,34,35 .…”

“…Furthermore, among those patients with extrafoveal lesion treated with laser photocoagulation, up to 54% suffered recurrence (defined by leakage of fluorescein at the periphery of the laser scar later than 6 weeks after treatment) after a 5-year follow-up 18, 30, 31. In the juxtafoveal and subfoveal groups of patients similarly recurrence occurred in 47 and 35% respectively 27,32,34 . Nowadays, it is becoming evident that the available techniques for laser photocoagulation of choroidal neovascular membranes due to AMD will not have a major impact on blindness due to AMD, despite early expectations 24,27,34,35 . Prevention therapy with laser photocoagulation of soft drusen emerged as an alternative form of treatment, evaluated by a series of clinical trials [36][37][38][39][40] .…”

Visual function after strontium‐90 plaque irradiation in patients with age‐related subfoveal choroidal neovascularization

“…Although laser photocoagulation is of value in many eyes with well-defined extrafoveal or small subfoveal CNVMs (MPS 1991, MPS 1993, MPS 1994, the great majority of patients with AMD show poorly defined or extensive subretinal neovascular lesions for which no established guidelines for treatment are available (Moisseiev et al 1995).…”

“…Laser photocoagulation has been proven to be of benefit only for a minority of patients: those having well-defined extrafoveal or juxtafoveal lesions or small, well-defined subfoveal CNVMs (Macular Photocoagulation Study Group (MPS) 1990, MPS 1991, MPS 1994, MPS 1994. The great majority of patients, however, already have poorly defined and/or large subfoveal lesions on initial presentation (Freund et al 1993;Moisseiev et al 1995), and are thus not eligible for laser photocoagulation based on current treatment guidelines established by the MPS. In addition, recurrent or persistent neovascularization is noted in about half the treated lesions (MPS 1994), and results in poor visual outcome.…”