title: Intravitreal therapy for neovascular age-related macular degeneration and inter-individual variations in vitreous pharmacokinetics.
abstract: This article aims to provide an interpretation and perspective on current concepts and recent literature regarding the evidence for individualizing intravitreal therapy (IVT), particularly considering iatrogenic and patient factors in the management of neovascular age-related macular degeneration (AMD). As ocular parameters that govern IVT pharmacokinetics do vary between individuals with AMD, developing a personalized strategy could improve safety and efficacy. This has to be derived from clinical measurements and data from laboratory animals; however, it is recognized that the animal models used in the development of intraocular formulations differ in their vitreous geometry from humans. These factors may be of relevance to the design of ophthalmic formulations and optimizing treatment outcomes in AMD. Further studies are needed to drive improvements in clinical practice which are aimed at maximizing the efficacy profile in IVT for AMD by a more rigorous evaluation of patient and surgeon-related variables.
authors.affiliation: Princess Alexandra Eye Pavilion, NHS Lothian, United Kingdom.
authors.forename: Augustinus
authors.initials: A
authors.lastname: Laude
authors.forename: Lay Ean
authors.initials: LE
authors.lastname: Tan
authors.forename: Clive G
authors.initials: CG
authors.lastname: Wilson
authors.forename: Gerassimos
authors.initials: G
authors.lastname: Lascaratos
authors.forename: Mohammed
authors.initials: M
authors.lastname: Elashry
authors.forename: Tariq
authors.initials: T
authors.lastname: Aslam
authors.forename: Niall
authors.initials: N
authors.lastname: Patton
authors.forename: Baljean
authors.initials: B
authors.lastname: Dhillon
mesh_terms: D020533:Angiogenesis Inhibitors / Q000493:pharmacokinetics* / Q000627:therapeutic use; D000818:Animals; D020256:Choroidal Neovascularization / Q000150:complications / Q000628:therapy*; D006801:Humans; D007206:Individuality; D058449:Intravitreal Injections / Q000295:instrumentation / Q000379:methods*; D008268:Macular Degeneration / Q000503:physiopathology* / Q000628:therapy*; D008954:Models, Biological; D014821:Vitrectomy / Q000379:methods; D014822:Vitreous Body / Q000033:anatomy & histology / Q000378:metabolism / Q000473:pathology
chemical_list: D020533:Angiogenesis Inhibitors