The Role of Inflammation in Age-Related Macular Degeneration-Therapeutic Landscapes in Geographic Atrophy

• Published in: Cells (Basel, Switzerland) Vol. 12; no. 16; p. 2092
• Main Authors: Borchert, Grace A, Shamsnajafabadi, Hoda, Hu, Monica L, De Silva, Samantha R, Downes, Susan M, MacLaren, Robert E, Xue, Kanmin, Cehajic-Kapetanovic, Jasmina
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.08.2023; MDPI
• Subjects: Age; age-related macular degeneration; AMD; Analysis; Angiogenesis Inhibitors; Atrophy; Care and treatment; Clinical trials; Complement component C3; Complement component C5; Complement system; Diagnosis; FDA approval; gene therapy; Genomes; geographic atrophy; Geographic Atrophy - therapy; Humans; Inflammation; Lectins; Macular degeneration; Medical imaging; Middle Aged; Neuroprotection; Neutrophils; optogenetics; Oxidative stress; Pathogenesis; Photoreceptors; Proteins; Retina; Review; Risk factors; Stem cells; Tomography; Transplantation; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A; Vision; Visual Acuity; Visual perception; Wet Macular Degeneration; United Kingdom; AMD; gene therapy; geographic atrophy; inflammation; age-related macular degeneration; optogenetics
• ISSN: 2073-4409; 2073-4409
• DOI: 10.3390/cells12162092

Age-related macular degeneration (AMD) is the leading cause of vision loss and visual impairment in people over 50 years of age. In the current therapeutic landscape, intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapies have been central to the management of neovascular AMD (also known as wet AMD), whereas treatments for geographic atrophy have lagged behind. Several therapeutic approaches are being developed for geographic atrophy with the goal of either slowing down disease progression or reversing sight loss. Such strategies target the inflammatory pathways, complement cascade, visual cycle or neuroprotective mechanisms to slow down the degeneration. In addition, retinal implants have been tried for vision restoration and stem cell therapies for potentially a dual purpose of slowing down the degeneration and restoring visual function. In particular, therapies focusing on the complement pathway have shown promising results with the FDA approved pegcetacoplan, a complement C3 inhibitor, and avacincaptad pegol, a complement C5 inhibitor. In this review, we discuss the mechanisms of inflammation in AMD and outline the therapeutic landscapes of atrophy AMD. Improved understanding of the various pathway components and their interplay in this complex neuroinflammatory degeneration will guide the development of current and future therapeutic options, such as optogenetic therapy.