title: Current treatment strategies for age-related ocular conditions.
abstract: Treatment for several major age-related ocular diseases has undergone a paradigm shift in recent years. Advances in basic science and clinical research have led to a more thorough understanding of the complex pathophysiology underlying common ocular diseases of aging, and to the development of highly effective new therapies for these conditions. The use of intraocular anti-angiogenic drugs, for example, has transformed the management of neovascular age-related macular degeneration and diabetic retinopathy. Many patients achieve impressive and durable gains in vision with these agents that were unattainable with older treatments. For glaucoma and dry eye disease, clinicians have a variety of pharmacologic and surgical options to choose from. However, significant challenges remain: not all patients respond to treatment, many older patients have difficulty complying with complex drug regimens, frequent office visits put a substantial strain on patients and caregivers, and therapies may cause unpleasant side effects. This article reviews the current treatment landscape for 4 major age-related ocular diseases: age-related macular degeneration, glaucoma, diabetic retinopathy, and dry eye.
authors.affiliation: Ocular Surface Disease & Dry Eye Clinic and Division of Cornea, Cataract, & External Diseases, The Wilmer Eye Institute, The Johns Hopkins School of Medicine, Baltimore, MD, USA. Esakpek@jhmi.edu
authors.forename: Esen K
authors.initials: EK
authors.lastname: Akpek
authors.forename: Roderick A
authors.initials: RA
authors.lastname: Smith
mesh_terms: D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000068258:Bevacizumab; D002986:Clinical Trials as Topic; D016572:Cyclosporine / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000517:prevention & control*; D018450:Disease Progression; D015352:Dry Eye Syndromes / Q000209:etiology / Q000628:therapy*; D005901:Glaucoma / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008268:Macular Degeneration / Q000188:drug therapy*; D055118:Medication Adherence; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D013508:Ophthalmologic Surgical Procedures; D000069579:Ranibizumab; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D016572:Cyclosporine; D006442:Glycated Hemoglobin; D009883:Ophthalmic Solutions; D000069579:Ranibizumab; D040262:Receptors, Vascular Endothelial Growth Factor; D011993:Recombinant Fusion Proteins; D042461:Vascular Endothelial Growth Factor A; C517652:hemoglobin A1c protein, human; C533178:aflibercept