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Ophthalmologica. Journal International... 2024The aim of this review was to systematically summarize the current knowledge on type 3 macular neovascularization (MNV3) in age-related macular degeneration (AMD). (Review)
Review
BACKGROUND
The aim of this review was to systematically summarize the current knowledge on type 3 macular neovascularization (MNV3) in age-related macular degeneration (AMD).
SUMMARY
Recent histopathologic and multimodal imaging findings led to the consensus definition of the new term "type 3 macular neovascularization" in AMD. MNV3 originates in the deep vascular plexus as a neovascular process without connection with the retinal pigment epithelium in the initial stages. This type has numerous clinical and pathomorphologic features that separate it from the other two types of MNV in AMD. Besides, its frequency appears to be higher than previously thought. In optical coherence tomography (OCT), MNV3 can be classified into stages 1-3. Hyperreflective foci in the outer retina possibly represent a precursor lesion. In addition, MNV3 is characterized by a strong association with reticular pseudodrusen, a high rate of bilaterality, close associations with advanced age and arterial hypertension, decreased choroidal thickness, and decreased choriocapillaris flow signals. Data from latest anti-vascular endothelial growth factor studies in MNV3 suggest that the OCT biomarkers in intraretinal and subretinal fluids should be interpreted differently than in the other types. Additionally, data from MNV3 eyes should be analyzed separately, allowing optimal type-specific treatment strategies in the future.
KEY MESSAGES
This review highlights the need for accurate characterization of neovascular AMD lesions and an MNV type-specific approach, particularly for MNV3.
Topics: Humans; Fluorescein Angiography; Fundus Oculi; Macula Lutea; Macular Degeneration; Retinal Pigment Epithelium; Tomography, Optical Coherence; Wet Macular Degeneration
PubMed: 38266500
DOI: 10.1159/000536278 -
Postgraduate Medical Journal Jun 2024Age-related macular degeneration (AMD) stands as a leading cause of irreversible blindness, particularly affecting central vision and impeding daily tasks. This paper... (Review)
Review
Age-related macular degeneration (AMD) stands as a leading cause of irreversible blindness, particularly affecting central vision and impeding daily tasks. This paper provides a thorough exploration of AMD, distinguishing between its two main subtypes-Wet and Dry AMD-while shedding light on the prevalence and risk factors, including age, genetics, and smoking. The focus shifts to the current and future treatment landscape, examining both Dry and Wet AMD. Regarding Dry AMD, interventions such as antioxidant supplementation and ongoing clinical trials offer hope. Notable among these is Pegcetacoplan which is the only Food and Drug Administration (FDA)-approved medication, displaying promising results in reducing geographic atrophy lesions. For Wet AMD, anti-Vascular Endothelial Growth Factor therapies like Ranibizumab (Lucentis®) have been instrumental, and newer drugs like Faricimab and OPT-302 show comparable efficacy with extended dosing intervals. Additionally, gene therapies such as RGX-314 present a potential paradigm shift, reducing or eliminating the need for frequent injections. Biosimilars offer cost-effective alternatives. The paper also delves into the integration of technology and artificial intelligence in AMD management, highlighting the role of smartphone apps for patient monitoring and artificial intelligence algorithms for diagnosis and surveillance. Furthermore, patient perspectives on artificial intelligence demonstrate a positive correlation between understanding and trust. The narrative concludes with a glimpse into ground-breaking technologies, including retinal implants and bionic chips, offering hope for vision restoration. Overall, this paper underscores the multifaceted approach in addressing AMD, combining traditional and innovative strategies, paving the way for a more promising future in AMD treatment.
Topics: Humans; Angiogenesis Inhibitors; Macular Degeneration; Genetic Therapy; Ranibizumab; Risk Factors; Wet Macular Degeneration; Artificial Intelligence
PubMed: 38330506
DOI: 10.1093/postmj/qgae016 -
Nutricion Hospitalaria Apr 2015nutritional components such as antioxidants may modify the risk of Macular Degeneration Age-related (AMD). This article is a systematic review of published studies... (Review)
Review
OBJECTIVE
nutritional components such as antioxidants may modify the risk of Macular Degeneration Age-related (AMD). This article is a systematic review of published studies relating to the modification of lifestyle, nutrition and vitamin intake to prevent or delay the onset or progression of Macular Degeneration Age-related (AMD).
RESULTS
the analysis of the results of research consulted shows that AMD is one of the most common causes of blindness in individuals over 55 years. AMD is characterized by decreased vision, metamorphopsias, macropsias, micropsias and central scotoma. Disease that must be diagnosed early because it can lead to irreversible blindness. Between components of the diet in many epidemiological studies have shown an inverse association with AMD and are reviewed in this paper are: vitamins (vitamin E and C), minerals (eg. zinc, selenium, manganese and copper) and carotenoids.
CONCLUSIONS
there is substantial evidence that can be applied nutritional support for patients with AMD. This requires determining the nutritional benefits of these nutrients (vitamins, minerals and carotenoids) or nutraceutical foods for health in this group of patients.
Topics: Dietary Supplements; Humans; Macular Degeneration; Micronutrients; Nutritional Status; Nutritive Value
PubMed: 26262695
DOI: 10.3305/nh.2015.32.1.9099 -
Maturitas May 2010Age-related macular degeneration (AMD) is a leading cause of vision loss in people over the age of 60 with a prevalence that continues to rise, particularly in... (Review)
Review
Age-related macular degeneration (AMD) is a leading cause of vision loss in people over the age of 60 with a prevalence that continues to rise, particularly in industrialized nations. Although treatments for AMD were once limited, with disappointing clinical results, new treatments have emerged for both the nonexudative and exudative forms of the disease, which have improved prognostic outcomes. These treatments include nutritional supplementation, antioxidant prophylaxis, and intravitreal injection of medications that inhibit aberrant vascular proliferation. This review serves as a summary of the current and experimental therapies for both exudative and nonexudative AMD. Although a number of challenges and clinical questions remain, the future of treating AMD appears promising particularly as we gain further insights into the genetic and biochemical pathways of the disease.
Topics: Aged; Antioxidants; Dietary Supplements; Humans; Macular Degeneration; Photochemotherapy; Vitreous Body
PubMed: 20219298
DOI: 10.1016/j.maturitas.2010.02.006 -
Bulletin of the New York Academy of... Dec 1988
Review
Topics: Aged; Combined Modality Therapy; Diagnosis, Differential; Female; Humans; Macular Degeneration; Male; Middle Aged; Retinal Detachment; Retinal Drusen; Risk Factors
PubMed: 3077076
DOI: No ID Found -
Trends in Molecular Medicine Sep 2004
Review
Topics: Aging; Animals; Eye; Humans; Immune System; Macular Degeneration
PubMed: 15350892
DOI: 10.1016/j.molmed.2004.07.004 -
Annals of the Academy of Medicine,... May 2002Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the developed western world, accounting for approximately 50% of all cases of... (Review)
Review
INTRODUCTION
Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the developed western world, accounting for approximately 50% of all cases of registered blindness. The rising prevalence of this disease in Asia seems to parallel the same trend in the developed world. Because of the socio-economic impact of this disorder, much attention has been paid to elucidating the underlying pathogenic mechanisms, as well as seeking alternative forms of treatment. This review discusses the latest advances in AMD diagnosis, treatment and prophylaxis.
METHODS
Medline search with emphasis on randomised controlled clinical trials and large case-control series. Only articles cited on the Index Medicus were included in this review.
RESULTS
Recent advances in the diagnosis and treatment of AMD include conventional argon laser photocoagulation, photodynamic therapy (PDT), radiation therapy, surgical options and gene therapy.
CONCLUSIONS
There have been numerous advances in the management of AMD and exciting new research applications have emerged. The introduction of exciting new modalities, such as PDT, has revolutionised the approach to treating CNVM and their effects on central vision. However, there has been no breakthrough in achieving satisfactory outcomes with the available techniques for treating occult neovascular lesions. As results of large prospective randomised clinical trials evaluating new treatment alternatives become available, a treatment algorithm for neovascular AMD will emerge that best minimises visual loss and may even result in visual improvement.
Topics: Algorithms; Asia; Blindness; Cost of Illness; Decision Trees; Developed Countries; Developing Countries; Genetic Therapy; Humans; Light Coagulation; Macular Degeneration; Photochemotherapy; Prevalence; Primary Prevention; Radiotherapy; Severity of Illness Index; Socioeconomic Factors; Treatment Outcome
PubMed: 12061304
DOI: No ID Found -
Cleveland Clinic Journal of Medicine Dec 2003Any patient age 50 or older with distorted vision or vision loss may have age-related macular degeneration and should be immediately referred to an ophthalmologist.... (Review)
Review
Any patient age 50 or older with distorted vision or vision loss may have age-related macular degeneration and should be immediately referred to an ophthalmologist. Early diagnosis and treatment are essential to preserve the current level of vision. We outline risk factors, clinical signs, what happens to the retina, and what treatments are currently available, as well as recommendations about vitamin and mineral supplementation.
Topics: Age Factors; Antioxidants; Humans; Macular Degeneration; Middle Aged; Ophthalmologic Surgical Procedures; Photochemotherapy; Risk Factors; United States
PubMed: 14686682
DOI: 10.3949/ccjm.70.12.1017 -
Discovery Medicine Jan 2010Age-related Macular Degeneration (AMD) is the major cause of vision loss after age 50 in the United States. Although an important association of the complement cascade...
Age-related Macular Degeneration (AMD) is the major cause of vision loss after age 50 in the United States. Although an important association of the complement cascade with AMD has recently been made, we still do not understand the pathogenesis of the disease. AMD is characterized by loss of the retinal pigment epithelium (RPE) within the macula (i.e., the center of the retina), and in turn, loss of the overlying foveal photoreceptors. Since RPE and photoreceptors can both be generated from stem cells using cell culture, there is hope for future cell replacement therapy. But, aging changes in Bruch's membrane, the scaffold on which the RPE are anchored, may complicate such therapy, and require surgical repair of Bruch's membrane to provide a suitable environment for cell survival and function. We have referred to such a multipronged approach of surgical reconstruction of the macular architecture in conjunction with cell transplantation as Maculoplasty.
Topics: Bruch Membrane; Humans; Macular Degeneration; Middle Aged; Retinal Pigment Epithelium; Stem Cell Transplantation
PubMed: 20102679
DOI: No ID Found -
Disease Models & Mechanisms May 2015Age-related macular degeneration (AMD) is a complex neurodegenerative visual disorder that causes profound physical and psychosocial effects. Visual impairment in AMD is... (Review)
Review
Age-related macular degeneration (AMD) is a complex neurodegenerative visual disorder that causes profound physical and psychosocial effects. Visual impairment in AMD is caused by the loss of retinal pigmented epithelium (RPE) cells and the light-sensitive photoreceptor cells that they support. There is currently no effective treatment for the most common form of this disease (dry AMD). A new approach to treating AMD involves the transplantation of RPE cells derived from either human embryonic or induced pluripotent stem cells. Multiple clinical trials are being initiated using a variety of cell therapies. Although many animal models are available for AMD research, most do not recapitulate all aspects of the disease, hampering progress. However, the use of cultured RPE cells in AMD research is well established and, indeed, some of the more recently described RPE-based models show promise for investigating the molecular mechanisms of AMD and for screening drug candidates. Here, we discuss innovative cell-culture models of AMD and emerging stem-cell-based therapies for the treatment of this vision-robbing disease.
Topics: Animals; Humans; Macular Degeneration; Models, Biological; Stem Cell Transplantation
PubMed: 26035859
DOI: 10.1242/dmm.017236