Exudative age-related macular degeneration (AMD) – clinical knowledge treatment optimisation
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Published:
Mar 31, 2014
Keywords:
AMD, anti-VEGF therapy, treatment optimisation
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Abstract
Age-related Macular Degeneration (AMD) is the leading cause of blindness in developed countries. Vascular endothelial growth factor (VEGF) has emerged as a key factor playing role in patomechanism of wet AMD. Between 2004 and 2006, 3 anti-VEGF drugs were introduced to ophthalmology (pegaptanib, bewacyzumab i ranibizumab). Soon after in 2012 a new molecule – alfibercept was registered. Those VEGF inhibitors played a major role in wet AMD treatment. Over 71% of patients benefit from treatment while only 5% of cases faces visual impairment. From 55% to 71% of eyes have persistent retinal fluid despite injections. A small proportion of eyes that respond to initial therapy subsequently develop tachyphylaxis. In those cases modifying the protocol, switching drugs can individualize treatment to gain maximum anatomic and functional effect with minimum interventions.
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Gębka A. Exudative age-related macular degeneration (AMD) – clinical knowledge treatment optimisation. Ophthatherapy [Internet]. 2014Mar.31 [cited 2024May3];1(1):13-0. Available from: https://journalsmededu.pl/index.php/ophthatherapy/article/view/664
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References
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19. Kloeckener-Gruissem B, Barthelmes D, Labs S et al. Genetic association with response to intravitreal ranibizumab in patients with neovascular AMD. Invest Ophthalmol Vis Sci. 2011; 52: 4694-702.
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21. Coppens G, Spielberg L, Leys A. Polypoidal choroidal vasculopathy, diagnosis and management. Bull Soc Belge Ophtalmol. 2011; 317: 39-44.
22. Mojana F, Cheng L, Bartsch DU et al. The role of abnormal vitreomacular adhesion in age-related macular degeneration: spectral optical coherence tomography and surgical results. Am J Ophthalmol. 2008; 146: 218-27.
23. Martin DF, Maguire MG, Ying GS. Ranibizumab and bevacizumab for neovascular age-related macular degeneration. N Engl J Med. 2011; 364: 1897-908.
24. Gasperini JL, Fawzi AA, Khondkaryan A et al. Bevacizmab and ranibizumab tachyphylaxis in the treatment of choroidal neovascularization. Br J Ophthalmol. 2012; 96: 14-20.
25. Stewart MW, Rosenfeld PJ, Penha FM et al. Pharmacokinetic rationale for dosing every 2 weeks versus 4 weeks with intravitreal ranibizumab, bevacizumab, and aflibercept (vascular endothelial growth factor Trap-eye). Retina. 2012; 32: 434-7.
26. Ho VY, Yeh S, Olsen TW et al. Short-term outcomes of aflibercept for neovascular age-related macular degeneration in eyes previously treated with other vascular endothelial growth factor inhibitors. Am J Ophthalmol. 2013; 156: 23-8.
27. Cousins S. ICG-directed photodynamic therapy for patients with refractory wet AMD. Presented at Retina 2014, Poipu, HI, January 20, 2014.
28. Holz F. Bandello F. Gillies M et al.; LUMINOUS Steering Committee. Safety of ranibizumab in routine clinical practice: 1-year retrospective pooled analysis of four European neovascular AMD registries within the LUMINOUS programme. Br J Ophthalmol. 2013; 97: 1161-7.
29. Tseng JJ, Vance SK, Della Torre KE et al. Sustained increased intraocular pressure related to intravitreal antivascular endothelial growth factor therapy for neovascular age-related macular degeneration. J Glaucoma. 2012; 21(4): 241-7.
2. Friedman DS, O’Colmain BJ, Munoz B et al. Prevalence of age-related macular degeneration in the United States. Arch Ophthalmol. 2004; 122(4): 564-72.
3. Ferris FL 3rd, Fine SL, Hyman L. Age-related macular degeneration and blindness due to neovascular maculopathy. Arch Ophthalmol. 1984; 102(11): 1640-2.
4. Klein R, Klein BE, Linton KL et al. The Beaver Dam Eye Study: the relation of age-related maculopathy to smoking. Am J Epidemiol. 1993; 137(2): 190-200.
5. Kwak N, Okamoto N, Wood JM et al. VEGF is major stimulator in model of choroidal neovascularization. Invest Ophthalmol Vis Sci. 2000; 41(10): 3158-64.
6. Krzystolik MG, Afshari MA, Adamis AP et al. Prevention of experimental choroidal neovascularization with intravitreal antivascular endothelial growth factor antibody fragment. Arch Ophthalmol. 2002; 120(3): 338-46.
7. Ferrara N, Damico L, Shams N et al. Development of ranibizumab, an anti-vascular endothelial growth factor antigen binding fragment, as therapy for neovascular age- related macular degeneration. Retina. 2006; 26(8): 859-70.
8. Holash J, Davis S, Papadopoulos N et al. VEGF-Trap: a VEGF blocker with potent antitumor effects. Proc Natl Acad Sci USA. 2002; 99(17): 11393-98.
9. Treatment of age-related macular degeneration with photodynamic therapy (TAP) study group. Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: One-year results of 2 randomized clinical trials – TAP report. Arch Ophthalmol. 1999; 117: 1329-45.
10. Rosenfeld PJ, Brown DM, Heier JS et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006; 355(14): 1419-31.
11. Brown DM, Kaiser PK, Michels M et al. Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med. 2006; 355(14): 1432-44.
12. Rosenfeld PJ, Moshfeghi AA, Puliafito CA. Optical coherence tomography after an intravitreal injection of bevacizumab (Avastin) for neovascular age-related macular degeneration. Ophthalmic Surg. Lasers Imaging. 2005; 36: 331-5.
13. Martin DF, Maguire MG, Fine SL et al; Comparison of Age-related Macular Degeneration Treatments Trials (CATT) Research Group. Ranibizumab and bevacizumab for treatment of neovascular age-related macular degeneration: two year results. Ophthalmology. 2012; 119(7): 1388-98.
14. Chakravarthy U, Harding SP, Rogers CA et al; The IVAN Study Investigators Writing Committee. Ranibizumab versus Bevacizumab to Treat Neovascular Age-related Macular Degeneration: One-Year Findings from the IVAN Randomized Trial. Ophthalmology. 2012; 119(7): 1399-411.
15. Stewart MW, Rosenfeld PJ. Predicted biological activity of intravitreal VEGF trap. Br J Ophthalmol. 2008; 92: 667-8.
16. Regeneron Pharmaceuticals Inc. VEGF Trap-Eye (aflibercept ophthalmic solution) Briefing Document. June 17, 2011. Online: http://www.fda.gov/downloads/AdvisoryCommittees/Committees Meeting Materials /Drugs/ Dermatologic and Ophthalmic Drugs Advisory Committee/UCM259143.pdf. (Access: 22.03.2012).
17. Kocić I. Przeciwciała monoklonalne a białka fuzyjne. Służba Zdrowia. 2012; 26-33: 74-5.
18. Holz FG, Amoaku W, Donate J et al; SUSTAIN Study Group. Safety and efficacy of a flexible dosing regimen of ranibizumab in neovascular age-related macular degeneration: the SUSTAIN study. Ophthalmology. 2011; 118(4): 663-71.
19. Kloeckener-Gruissem B, Barthelmes D, Labs S et al. Genetic association with response to intravitreal ranibizumab in patients with neovascular AMD. Invest Ophthalmol Vis Sci. 2011; 52: 4694-702.
20. Hemeida TS, Keane PA, Dustin L et al. Long-term visual and anatomical outcomes following anti-VEGF monotherapy for retinal angiomatous proliferation. Br J Ophthalmol. 2010; 94: 701-5.
21. Coppens G, Spielberg L, Leys A. Polypoidal choroidal vasculopathy, diagnosis and management. Bull Soc Belge Ophtalmol. 2011; 317: 39-44.
22. Mojana F, Cheng L, Bartsch DU et al. The role of abnormal vitreomacular adhesion in age-related macular degeneration: spectral optical coherence tomography and surgical results. Am J Ophthalmol. 2008; 146: 218-27.
23. Martin DF, Maguire MG, Ying GS. Ranibizumab and bevacizumab for neovascular age-related macular degeneration. N Engl J Med. 2011; 364: 1897-908.
24. Gasperini JL, Fawzi AA, Khondkaryan A et al. Bevacizmab and ranibizumab tachyphylaxis in the treatment of choroidal neovascularization. Br J Ophthalmol. 2012; 96: 14-20.
25. Stewart MW, Rosenfeld PJ, Penha FM et al. Pharmacokinetic rationale for dosing every 2 weeks versus 4 weeks with intravitreal ranibizumab, bevacizumab, and aflibercept (vascular endothelial growth factor Trap-eye). Retina. 2012; 32: 434-7.
26. Ho VY, Yeh S, Olsen TW et al. Short-term outcomes of aflibercept for neovascular age-related macular degeneration in eyes previously treated with other vascular endothelial growth factor inhibitors. Am J Ophthalmol. 2013; 156: 23-8.
27. Cousins S. ICG-directed photodynamic therapy for patients with refractory wet AMD. Presented at Retina 2014, Poipu, HI, January 20, 2014.
28. Holz F. Bandello F. Gillies M et al.; LUMINOUS Steering Committee. Safety of ranibizumab in routine clinical practice: 1-year retrospective pooled analysis of four European neovascular AMD registries within the LUMINOUS programme. Br J Ophthalmol. 2013; 97: 1161-7.
29. Tseng JJ, Vance SK, Della Torre KE et al. Sustained increased intraocular pressure related to intravitreal antivascular endothelial growth factor therapy for neovascular age-related macular degeneration. J Glaucoma. 2012; 21(4): 241-7.