Management of Neovascular Age-related Macular Degeneration: A Review on Landmark Randomized Controlled Trials

Middle East Afr J Ophthalmol. 2016 Jan-Mar;23(1):27-37. doi: 10.4103/0974-9233.173133.

Abstract

In the last decade, a number of prospective clinical trials with carefully designed study protocols have been conducted for the treatment of neovascular age-related macular degeneration (AMD). These landmark clinical trials such as ANCHOR and MARINA and, more recently, the Comparison of AMD Treatment Trials and VIEW studies have revolutionized the management of neovascular AMD. While AMD continues to remain a leading cause of severe visual loss worldwide, advances in pharmacotherapeutics have led to substantial improvements in the outcome of these patients. The introduction of anti-vascular endothelial growth factor agents has resulted in improvement of visual outcomes and has had a positive impact on the quality of life among elderly population. While the contemporary management of neovascular AMD has been successful in tremendously reducing the visual morbidity, the financial burden of therapy has increased exponentially. To overcome these challenges, newer pharmacologic agents are evaluated for their efficacy and safety in AMD. Ground-breaking advances in bench to bedside research have led to discovery of new pathways that appear to be viable targets for preventing visual loss in AMD. In this review, study designs and results of landmark clinical trials in AMD from the past decade have been summarized.

Keywords: Aflibercept; Bevacizumab; Choroidal Neovascularization; Clinical Trials; Intravitreal Therapy; Ranibizumab; Retina; Wet Age-related Macular Degeneration; macular Degeneration.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use*
  • Bevacizumab / therapeutic use
  • Humans
  • Intravitreal Injections
  • Quality of Life / psychology
  • Randomized Controlled Trials as Topic*
  • Ranibizumab / therapeutic use
  • Receptors, Vascular Endothelial Growth Factor / therapeutic use
  • Recombinant Fusion Proteins / therapeutic use
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / drug effects
  • Visual Acuity / physiology
  • Wet Macular Degeneration / drug therapy*
  • Wet Macular Degeneration / physiopathology
  • Wet Macular Degeneration / psychology

Substances

  • Angiogenesis Inhibitors
  • Recombinant Fusion Proteins
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • aflibercept
  • Bevacizumab
  • Receptors, Vascular Endothelial Growth Factor
  • Ranibizumab