Current therapeutic approaches in neovascular age-related macular degeneration

Abstract

Age-related macular degeneration (AMD) is the leading eye disease to cause visual impairment in the elderly. Neovascular AMD is a type of advanced AMD that is characterized by pathologic proliferation and leakage of abnormal blood vessels in the eye. While the pathogenesis of neovascular AMD is not completely known, one of the important milestones in neovascular AMD research was the identification of vascular endothelial growth factor (VEGF) as a major stimulus of abnormal angiogenesis that can be targeted for intravitreal treatment. Anti-VEGF therapies that neutralize or block the induction of angiogenesis by VEGF have recently revolutionized the therapeutic approach to neovascular AMD. The scientific literature regarding the efficacy and safety of anti-VEGF treatment has been hugely enriched with results from various recent randomized clinical trials involving the three most commonly utilized anti-VEGF pharmacologic agents--ranibizumab, bevacizumab, and aflibercept. The potential to stop and reverse the progressive loss of vision due to neovascular AMD is evident. Continued investigation into inhibiting VEGF as well as targeting other crucial factors that contribute to neovascular AMD is an active field of research that is expected to accelerate the progress of neovascular AMD therapy.