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Review
. 2021 Sep 30;22(19):10594.
doi: 10.3390/ijms221910594.

Ocular Therapeutics and Molecular Delivery Strategies for Neovascular Age-Related Macular Degeneration (nAMD)

Aira Sarkar  1 , Vijayabhaskarreddy Junnuthula  2 , Sathish Dyawanapelly  3
Affiliations
Review

Ocular Therapeutics and Molecular Delivery Strategies for Neovascular Age-Related Macular Degeneration (nAMD)

Aira Sarkar et al. Int J Mol Sci. .

Abstract

Age-related macular degeneration (AMD) is the leading cause of vision loss in geriatric population. Intravitreal (IVT) injections are popular clinical option. Biologics and small molecules offer efficacy but relatively shorter half-life after intravitreal injections. To address these challenges, numerous technologies and therapies are under development. Most of these strategies aim to reduce the frequency of injections, thereby increasing patient compliance and reducing patient-associated burden. Unlike IVT frequent injections, molecular therapies such as cell therapy and gene therapy offer restoration ability hence gained a lot of traction. The recent approval of ocular gene therapy for inherited disease offers new hope in this direction. However, until such breakthrough therapies are available to the majority of patients, antibody therapeutics will be on the shelf, continuing to provide therapeutic benefits. The present review aims to highlight the status of pre-clinical and clinical studies of neovascular AMD treatment modalities including Anti-VEGF therapy, upcoming bispecific antibodies, small molecules, port delivery systems, photodynamic therapy, radiation therapy, gene therapy, cell therapy, and combination therapies.

Keywords: age-related macular degeneration; bispecific antibodies; cell therapy; gene therapy; ocular therapeutics; port delivery system.

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Conflict of interest statement

The authors declare no conflict of interest. The authors declare no competing financial interest.

Figures

Figure 1
Figure 1
Anatomical and Pathophysiological features of retina cell layers in neovascular AMD. Normal Vision and wet AMD.
Figure 2
Figure 2
Ocular therapeutics and molecular delivery strategies for neovascular AMD.
Figure 3
Figure 3
Port Delivery System with ranibizumab (PDS) implant. Port Delivery System with ranibizumab implant (A); Patient images from a PDS-implanted patient with: (B) eye in primary position (implant not visible); (C) eye looking up with implant visible through dilated pupil; and (D) eye looking down to visualize PDS septum. Reprinted from ref [158] with permission from Elsevier.
Figure 4
Figure 4
Cell therapy strategies for neovascular AMD.
See this image and copyright information in PMC

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