Promising new treatments for neovascular age-related macular degeneration.
Angiogenesis, the growth of new blood vessels from existing blood vessels, is responsible for vision loss in a variety of ophthalmic diseases. In neovascular age-related macular degeneration (AMD), the leading cause for legal blindness in many industrialised countries, abnormal blood vessels grow in the macula and cause blindness. There are a number of factors important in the angiogenic cascade but VEGF-A has been implicated in recent years as the major factor responsible for neovascular and exudative diseases of the eye. Numerous antiangiogenic drugs are in development but anti-VEGF drugs have shown great promise in treating neovascular AMD and other ocular diseases, and many of these drugs have been adopted from oncology where antiangiogenic therapy is gaining wide acceptance. For the first time in neovascular AMD, anti-VEGF drugs have brought the hope of vision improvement to a significant proportion of patients. This review provides an overview on angiogenic mechanisms, potential antiangiogenic treatment strategies and different antiangiogenic drugs with special focus on neovascular AMD.
Michels
Stephan
S
Klinik für Augenheilkunde und Optometrie, Medizinische Universität Wien, Währinger Gürtel 18-20, Allgemeines Krankenhaus 8i, 1090 Wien/Vienna, Austria. stephan.michels@meduniwien.ac.at
Schmidt-Erfurth
Ursula
U
Rosenfeld
Philip J
PJ
D000375:Aging; D020533:Angiogenesis Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide / Q000627:therapeutic use; D000068258:Bevacizumab; D002199:Capillary Permeability / Q000187:drug effects; D002777:Cholestanols / Q000627:therapeutic use; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D004311:Double-Blind Method; D015195:Drug Design; D015507:Drugs, Investigational / Q000494:pharmacology / Q000627:therapeutic use*; D005136:Eye Proteins / Q000502:physiology; D006801:Humans; D007267:Injections; D007773:Lactates / Q000627:therapeutic use; D008268:Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology; D023421:Models, Animal; D015337:Multicenter Studies as Topic; D009389:Neovascularization, Pathologic / Q000188:drug therapy*; D009414:Nerve Growth Factors / Q000502:physiology; D010857:Pigment Epithelium of Eye / Q000378:metabolism / Q000473:pathology; D020033:Protein Isoforms / Q000037:antagonists & inhibitors / Q000502:physiology; D034622:RNA Interference; D034741:RNA, Small Interfering / Q000494:pharmacology / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D015843:Serpins / Q000502:physiology; D013267:Stilbenes / Q000627:therapeutic use; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors* / Q000494:pharmacology / Q000502:physiology; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000187:drug effects / Q000502:physiology; D014822:Vitreous Body; D000099174:Pigment Epithelium-Derived Factor
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide; D000068258:Bevacizumab; D002777:Cholestanols; D015507:Drugs, Investigational; D005136:Eye Proteins; D007773:Lactates; D009414:Nerve Growth Factors; D020033:Protein Isoforms; D034741:RNA, Small Interfering; D015843:Serpins; D013267:Stilbenes; D042461:Vascular Endothelial Growth Factor A; D040301:Vascular Endothelial Growth Factor Receptor-2; D000099174:Pigment Epithelium-Derived Factor; C495058:pegaptanib; C488568:squalamine lactate; C058728:fosbretabulin