Developmens in AMD.doc

Developments in AMD management keep pace with increase in incidence Cancer drugs are showing promise for the wet form; vitamins are helpful for the dry. Primary Care Optometry News, December 2010Len V Hua, OD PhD FAAO As life expectancy lengthens, the incidence of age-related macular degeneration increases proportionally. A large body of research is devoted to the treatment, prevention and monitoring of both the wet and the more common dry form of AMD. See Also Keep a long-term perspective in todays volatile market Researchers work to address increasing incidence of myopia ... Keep asking us the tough questions | Primary Care Optometry ... Wet AMD management Photocoagulation was the first approach devised in the late 1980s to destroy choroidal neovascular membranes (CNVMs). It reduced the risk of severe vision loss, but side effects included permanent scars and scotomas. Figure 1. Red-free fundus photo shows scattered drusen in the macula of the right eye. Image: Hua LV About a decade later, Visudyne (photodynamic therapy [PDT] with verteporfin, Novartis, QLT), a pharmacologic photosensitizer, was developed with more selective targeting of CNVM. Studies showed that the reduction in vision loss was similar, but with less retinal scarring. Vascular endothelial growth factors (VEGFs) have been well known as a dominant player in choroidal neovascularization as is seen with wet AMD. A few years after the PDT research, successful inhibition of the VEGF pathway by intravitreous administration was published in the VEGF Inhibition Study in Ocular Neovascularization (VISION) trial, showing that Macugen (pegaptanib sodium, Eyetech), a pegylated aptamer (short RNA oligonucleotide) that works against VEGF165, reduced the risk of moderate vision loss significantly with minimal side effects. Two years later in 2006, Lucentis (ranibizumab, Genentech), a new recombinant monoclonal antibody against multiple VEGF isoforms, was reported by the MARINA and ANCHOR trials to not