Neovascular Age-Related Macular Degeneration: Therapeutic Management and New-Upcoming Approaches

• Published in: International journal of molecular sciences Vol. 21; no. 21; p. 8242
• Main Authors: Ricci, Federico, Bandello, Francesco, Navarra, Pierluigi, Staurenghi, Giovanni, Stumpp, Michael, Zarbin, Marco
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI 03.11.2020; MDPI AG
• Subjects: age-related macular degeneration; Ang-2; Angiogenesis Inhibitors - administration & dosage; Angiogenesis Inhibitors - adverse effects; anti-VEGF; Drug Administration Schedule; Humans; Intravitreal Injections; Macular Degeneration - complications; Macular Degeneration - epidemiology; Macular Degeneration - therapy; Medication Adherence - statistics & numerical data; neovascular AMD; neovascularization; Neovascularization, Pathologic - complications; Neovascularization, Pathologic - epidemiology; Neovascularization, Pathologic - therapy; Ranibizumab - administration & dosage; Ranibizumab - adverse effects; Review; vascular endothelial growth factor; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Vascular Endothelial Growth Factor A - immunology; Visual Acuity - drug effects; vascular endothelial growth factor; neovascularization; Ang-2; anti-VEGF; age-related macular degeneration; neovascular AMD; DARPins
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms21218242

Age-related macular degeneration (AMD) constitutes a prevalent, chronic, and progressive retinal degenerative disease of the macula that affects elderly people and cause central vision impairment. Despite therapeutic advances in the management of neovascular AMD, none of the currently used treatments cures the disease or reverses its course. Medical treatment of neovascular AMD experienced a significant advance due to the introduction of vascular endothelial growth factor inhibitors (anti-VEGF), which dramatically changed the prognosis of the disease. However, although anti-VEGF therapy has become the standard treatment for neovascular AMD, many patients do not respond adequately to this therapy or experience a slow loss of efficacy of anti-VEGF agents after repeated administration. Additionally, current treatment with intravitreal anti-VEGF agents is associated with a significant treatment burden for patients, caregivers, and physicians. New approaches have been proposed for treating neovascular AMD. Among them, designed ankyrin repeat proteins (DARPins) seem to be as effective as monthly ranibizumab, but with greater durability, which may enhance patient compliance with needed injections.