Authors: Grant M. Comer¹; Thomas A. Ciulla²; Mark H. Criswell³; Michael Tolentino

Source: Drugs & Aging, Volume 21, Number 15, 2004 , pp. 967-992(26)

Publisher: Adis International

Abstract:

Age-related macular degeneration (AMD) is the leading cause of irreversible visual loss in the industrialised world. Although relatively simple to diagnose through direct visualisation augmented with rapid sequence fluorescein angiography, treatment has presented a far greater challenge because the true aetiology of AMD is largely unknown. Within the past decade, researchers have introduced many new, potentially promising treatment and prevention options in an attempt to minimise the damage imparted from AMD. They capitalise on many of the theoretical and known factors contributing to AMD progression. A high-dose of an orally administered combination of the antioxidants ascorbic acid (vitamin C), tocopherol (vitamin E) and -carotene, in addition to copper and zinc, is the only widely accepted preventive therapy. Thermal laser photocoagulation and verteporfin photodynamic therapy are the only standard treatment options available based on large scale, randomised, prospective, placebo-controlled trials; however, efficacy is limited and only a minority of patients who present with AMD are eligible for these treatments. Many other preventive and treatment options are in all phases of clinical studies and expected to change the entire approach to AMD management in the near future. For example, alternative antioxidants, drusen ablation, apheresis and HMG-CoA reductase inhibitors have shown promise in some studies by preventing or slowing the progression of certain forms of AMD. In addition, alternative photodynamic therapies, low-intensity laser, antiangiogenic medications, radiation treatment and surgery have demonstrated the ability, albeit to differing degrees, to inhibit or possibly even reverse the severe vision loss often associated with AMD characterised by choroidal neovascularisation.

Keywords: Elderly; Age related macular degeneration; Antioxidants; Anecortave; Research and development; Angiogenesis inhibitors; Pegaptanib; Small interfering RNA; Antisense RNA; Ranibizumab; Antibodies; Prinomastat; Squalamine

Document Type: Research article

Affiliations: 1: 1 Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA 2: 2 Vitreoretinal Service, Midwest Eye Institute, Indianapolis, Indiana, USA 3: 3 Department of Ophthalmology, Retina Service Research Laboratories, Indiana University School of Medicine, Indianapolis, Indiana, USA

Publication date: 2004-01-01

Related content

• In this: publication
• By this: publisher
• In this Subject: Internal Medicine ,  Pharmacology
• By this author: Grant M. Comer ;  Thomas A. Ciulla ;  Mark H. Criswell ;  Michael Tolentino

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers