AGE-RELATED MACULAR DEGENERATION CURRENT INVESTIGATIONS AND TREATMENTS

agerelatedmaculardeg774enerationkapak

ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR TREATMENT IN AGE-RELATED MACULAR DEGENERATION

Pınar Çiçek Kaya

Ankara Etlik City Hospital, Department of Ophthalmology, Ankara, Türkiye

Çiçek Kaya P. Anti-Vascular Endothelial Growth Factor Treatment in AgeRelated Macular Degeneration. In: Çıtırık M, Şekeryapan Gediz B, editors. Age-Related Macular Degeneration: Current Investigations and Treatments. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.169-178.

ABSTRACT

Age-related macular degeneration (AMD) is the leading reason of irreversible vision loss worldwide. Its prevalence is expected to be 288 million by 2040, hence demanding the interest of healthcare workers. Wet AMD (wAMD) is an advanced stage of AMD with choroidal neovascularization (CNV) which leads to fluid accumulation, fibrosis, and bleeding within the macula. The management of wAMD is very challenging. Landmark studies have demonstrated the efficacy of different anti-vascular endothelial growth factor (anti-VEGF) therapies, evaluated the optimal dosing regimen over the past two decades, and delivery mechanisms to increase overall vision and minimize patient burden. The gold standard for wAMD consists of intravitreal injections of anti-VEGF drugs such as bevacizumab, ranibizumab, and aflibercept. Novel therapies for wAMD, including brolucizumab, faricimab, and aflibercept 8 mg, have shown visual improvements comparable to or superior to aflibercept 2 mg, the prevailing standard therapy. Therapy can be administered according to the fixed, pro-re-nata, and treatand-extend regimens. The latter appears to have the best effect in improving visual acuity and providing maximum therapeutic benefit. The searches continue on the best ways to deliver intravitreal drugs. Current methods include sustained-release implants and hydrogel platforms for drug release. The Port Delivery System (PDS) containing ranibizumab is the first refillable eye implant for the treatment of wAMD. This method may provide constant and prolonged anti-VEGF therapy.

Keywords: Macular degeneration; Anti-vascular endothelial growth factors; Aflibercept; Ranibizumab; Bevacizumab; Brolucizumab; Faricimab

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