Treatment of neovascular age-related macular degeneration: Current therapies

Abstract

Choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) is now the leading cause of blindness and severe vision loss among people over the age of 40 in the Western world. Its prevalence is certain to increase substantially as the population ages. Treatments currently available for the disease include laser photocoagulation, verteporfin photodynamic therapy, and intravitreal injections of corticosteroids and anti-angiogenic agents. Many studies have reported the benefits of each of these treatments, although none is without its risks. No intervention actually cures AMD, nor the neovascularization associated with it. However, its symptoms are treated with varying degrees of success. Some treatments stabilize or arrest the progress of the disease. Others have been shown to reverse some of the damage that has already been done. These treatments can even lead to visual improvement. This paper will review the major classes of drugs and therapies designed to treat this condition.

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“…4 Unfortunately, there is no cure for AMD and current treatment options have limited effectiveness and introduce significant patient risk. 6,7 Therefore, AMD prevention strategies should be identified and implemented. A number of AMD risk factors have been determined including older age, AMD family history, cigarette smoking, white race, and low dietary intake of antioxidants in the form of fruits and vegetables.…”

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“…PDT has been approved for the treatment of certain cancers [16,18] as well as various types of noncancerous conditions, including age-related macular degeneration [19]. The photodestructive effect or photodynamic action is based on the photoexcitation of a photoreactive drug-photosensitizer by light with a wavelength corresponding to the absorption band of the photosensitizer [20].…”

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“…In this procedure, verteporfin, a photosensitive dye, is administered by IV followed by activation of the dye with a laser light of 689nm wavelength. Laser excitation of verteporfin generates ROS which damages endothelial cells and induces occlusion of CNV [106]. Unlike laser photocoagulation, it specifically destroys the CNV without damaging the retina and underlying choroid.…”