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首页> 外文期刊>Middle East African Journal of Ophthalmology >The Past, Present, and Future of Exudative Age-Related Macular Degeneration Treatment
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The Past, Present, and Future of Exudative Age-Related Macular Degeneration Treatment

机译：与年龄相关的渗出性黄斑变性治疗的过去，现在和未来

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Treatment of exudative age-related macular degeneration has been revolutionized within the last 6 years with the introduction of vascular endothelial growth factor neutralizing agents. Previously popular “destructive treatments,” such as laser photocoagulation and photodynamic treatment have either been abandoned or used as an adjunct to pharmacotherapy. Despite the increase in vision after antivascular endothelial growth factor (VEGF) agents, they require repetitive and costly intravitreal injections that also carry the inherit risks of infection, retinal tears, and detachment. Several new and more potent VEGF inhibitors are at different stages of development. The goal of evolving pharmacotherapy is to preserve the therapeutic effect while reducing or eliminating the discomfort of intravitreal drug delivery, as well as identify new therapeutic targets. Complement inhibitors, immunomodulators, integrin inhibitors are a few of the new class of drugs that are expected to be in our armamentarium soon. Current medications act to decrease leakage through abnormal subretinal choroidal vasculature and promote involution. However, these medications are only effective in treating the active stage of the choroidal neovascular membrane. Restoration of vision of a large number of patients with involuted choroidal neovascular membranes is warranted. For this purpose, tissue engineering techniques have been employed to reconstruct the subretinal anatomy. Discovery of biomarkers, pharmacogenetics, and very specific targeting holds the promise of increased potency and safety in the future.Keywords: Age-Related Macular Degeneration, Choroidal Neovascularization, Geographic Atrophy, Pharmacotherapy, Retinal Pigment Epithelium, Tissue Engineering, Vascular Endothelial Growth Factor
机译：在过去的6年中，随着血管内皮生长因子中和剂的引入，对与年龄相关的渗出性黄斑变性的治疗进行了革新。以前流行的“破坏性治疗”，例如激光光凝和光动力治疗，已经被放弃或用作药物治疗的辅助手段。尽管使用抗血管内皮生长因子（VEGF）药物后视力有所提高，但它们仍需要重复且昂贵的玻璃体内注射，这也带来了感染，视网膜撕裂和脱离的遗传风险。几种新的更有效的VEGF抑制剂处于不同的开发阶段。不断发展的药物治疗的目标是在保持治疗效果的同时，减少或消除玻璃体内给药的不适感，并确定新的治疗靶标。补体抑制剂，免疫调节剂，整联蛋白抑制剂是有望很快出现在我们军械库中的新型药物中的一些。当前的药物用于减少通过异常的视网膜下脉络膜脉管系统的渗漏并促进内卷。然而，这些药物仅在治疗脉络膜新血管膜的活动期有效。大量的脉络膜新生血管膜卷入患者的视力恢复是必要的。为此目的，已经采用组织工程技术来重建视网膜下解剖结构。生物标记物，药物遗传学和非常特定的靶向的发现有望在未来提高效能和安全性。关键字：与年龄有关的黄斑变性，脉络膜新生血管，地理萎缩，药物治疗，视网膜色素上皮，组织工程，血管内皮生长因子

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